Individual
JAYNE L P MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LISW-S
Contact information
Practice address
4625 MORSE RD STE 200, GAHANNA, OH 43230-8355
(734) 395-1432
Mailing address
4625 MORSE RD STE 200, GAHANNA, OH 43230-8355
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
I.1000243
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08258
—
OH
Enumeration date
12/03/2007
Last updated
11/19/2024
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