Individual
JESSICA MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1060 WEBBER ST, THE DALLES, OR 97058-3749
(541) 296-5452
Mailing address
1060 WEBBER ST, THE DALLES, OR 97058-3749
(541) 296-5452
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
A14777
OR
Other
Enumeration date
10/30/2023
Last updated
08/14/2024
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