Individual
JENNIFER MELISSA MOSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MFT
Contact information
Practice address
12356 NE BRAZEE ST, PORTLAND, OR 97230-1841
(808) 281-1494
Mailing address
12356 NE BRAZEE ST, PORTLAND, OR 97230-1841
(808) 281-1494
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
295
HI
Other
Enumeration date
04/02/2020
Last updated
04/02/2020
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