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Individual

JORDAN MOONEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTR

Contact information

Practice address
7151 15TH ST S, FARGO, ND 58104-6613
(701) 364-2950
Mailing address
PO BOX 5007, MINOT, ND 58702-5007
(701) 852-3628
(701) 852-1190

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1735
ND

Other

Enumeration date
10/14/2019
Last updated
10/14/2019
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