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Individual

MRS. JIAYMETA MOORE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
239 ELM ST NE, ALBUQUERQUE, NM 87102-3672
(505) 242-1010
(505) 242-1515
Mailing address
2582 CAMINO PLATA LOOP NE, RIO RANCHO, NM 87144-5825
(575) 791-7785

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
175T00000X
Peer Specialist
1517
NM

Other

Enumeration date
07/12/2022
Last updated
03/31/2023
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