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1043979479
JASON EDWARD MOORE
SOUTH LAKE TAHOE, CA
NPI
1043979479
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Additional Taxonomies
101YM0800X Counselor, Mental Health
Enumeration Date
2021-12-13
Last Update Date
2024-06-24
Business Address
JASON EDWARD MOORE
1900 LAKE TAHOE BLVD
SOUTH LAKE TAHOE, CA 96150-6305
Phone number: 530-573-7970
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Mailing Address
JASON EDWARD MOORE
1900 LAKE TAHOE BLVD
SOUTH LAKE TAHOE, CA 96150-6305
Phone number: 530-573-7970
Copy
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