Individual
JESSICA LEE MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
2700 SNELLING AVE N STE 400, ROSEVILLE, MN 55113-1783
(763) 210-4698
Mailing address
3116 EMERSON AVE S APT 3, MINNEAPOLIS, MN 55408-2774
(763) 458-6143
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
29099
MN
Other
Enumeration date
09/07/2022
Last updated
11/28/2023
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