Individual
JAYNIE BRADLEY MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NCC, LPC, MHSP
Contact information
Practice address
315 HOME AVE, MARYVILLE, TN 37801-3970
(865) 300-4541
Mailing address
1635 MEADOW CHASE LN, KNOXVILLE, TN 37931-4748
(865) 300-4541
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2099
TN
Other
Enumeration date
10/19/2009
Last updated
10/19/2009
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