Individual
JONATHAN DAVID MOSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSW
Contact information
Practice address
399 W. KAWILI ST., #202, HILO, HI 96720-4086
(808) 657-8484
Mailing address
110 ALAE ST, HILO, HI 96720-2507
(808) 657-8484
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
4194
HI
Other
Enumeration date
10/22/2010
Last updated
04/07/2017
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