Individual
JACQUAN MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS
Contact information
Practice address
19605 ALGER ST, SAINT CLAIR SHORES, MI 48080-3336
(586) 943-6079
Mailing address
19605 ALGER ST, SAINT CLAIR SHORES, MI 48080-3336
(586) 943-6079
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
06/16/2021
Last updated
06/16/2021
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