Individual
JACINDA R MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
403 E MADISON ST, SOUTH BEND, IN 46617-2322
(574) 283-1107
(574) 283-1131
Mailing address
4240 ISISH HILL DRIVE, APT 2D, SOUTH BEND, IN 46614
(574) 360-8410
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
03/06/2007
Last updated
07/08/2007
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