Individual
MS. JILL LOUISE MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
18316 MIDDLEBELT RD, LIVONIA, MI 48152-5007
(248) 615-9730
Mailing address
13440 WINSTON, REDFORD, MI 48239
(248) 615-9730
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6301012292
MI
Other
Enumeration date
12/12/2006
Last updated
07/08/2007
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