Individual
JASON DON MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BSW, LSW
Contact information
Practice address
120 HARPER CT, BECKLEY, WV 25801-2650
(304) 255-7526
Mailing address
PO BOX 5084, BECKLEY, WV 25801-7500
(304) 255-7526
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
AP00944904
WV
Other
Enumeration date
06/30/2016
Last updated
07/15/2016
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