Individual
JASMINE ANTIONETTE MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S.
Contact information
Practice address
207 BLUE SAGE DR, HARVEST, AL 35749-8989
(601) 562-0523
Mailing address
207 BLUE SAGE DR, HARVEST, AL 35749-8989
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
02/23/2011
Last updated
02/23/2011
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