Individual
JENNIFER MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
348 PRIOR AVE N STE 205, SAINT PAUL, MN 55104-5591
(612) 743-7594
Mailing address
348 PRIOR AVE N STE 205, SAINT PAUL, MN 55104-5591
(612) 743-7594
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
CC00825
MN
Other
Enumeration date
05/23/2017
Last updated
05/23/2017
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