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1649692054
JERROLD MOORE
PLYMOUTH, IN
NPI
1649692054
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: IN 39001287A)
Enumeration Date
2014-01-21
Last Update Date
2014-01-21
Business Address
-- JERROLD MOORE LMHC
990 ILLINOIS ST
PLYMOUTH, IN 46563-3622
Phone number: 574-936-9646
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Mailing Address
-- JERROLD MOORE LMHC
850 N HARRISON ST
WARSAW, IN 46580-3163
Phone number: 574-267-7169
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