Individual
JANE MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
8230 OLD COURTHOUSE RD, VIENNA, VA 22182-3853
(434) 602-1280
Mailing address
PO BOX 145, MERRIFIELD, VA 22116-0145
(434) 602-1280
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904015958
VA
Other
Enumeration date
10/19/2023
Last updated
10/19/2023
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