Individual
JACOB MOULIERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1817 OLDE HOMESTEAD LN, LANCASTER, PA 17601-6751
(223) 275-3158
Mailing address
14 ROSELLE AVE, LANCASTER, PA 17603-6698
(609) 432-3081
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YP2500X
Professional Counselor
Primary
PC017036
PA
Other
Enumeration date
09/22/2021
Last updated
04/15/2025
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