Individual
JENNA LYNN MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CTRS
Contact information
Practice address
7794 PAINT CREEK DR, YPSILANTI, MI 48197-6139
(734) 352-3543
Mailing address
251 STEVENS DR APT 101, YPSILANTI, MI 48197-4529
(734) 352-3543
Taxonomy
Speciality
Code
Description
License number
State
225800000X
Recreation Therapist
Primary
88791
MI
Other
Enumeration date
04/21/2026
Last updated
04/21/2026
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