Individual
JONATHAN PERRY MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LLC
Contact information
Practice address
170 COLLEGE AVE STE 310, HOLLAND, MI 49423-2982
(616) 745-6748
Mailing address
170 COLLEGE AVE STE 310, HOLLAND, MI 49423-2982
(616) 745-6748
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6451023316
MI
Other
Enumeration date
10/17/2023
Last updated
10/17/2023
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