Individual
JALYN MOFFET
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4215 31ST AVE S STE A, FARGO, ND 58104-7743
(701) 478-0221
Mailing address
4215 31ST AVE S STE A, FARGO, ND 58104-7743
(701) 478-0221
(701) 478-0222
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
ND
106S00000X
Behavior Technician
Primary
—
—
174400000X
Specialist
—
—
Other
Enumeration date
09/20/2021
Last updated
06/08/2026
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