Jason Richard Ellsworth Moore, LSW

NPI #1114218864 in Ashland, Ohio

Provider Information

NPI Number: 1114218864
Entity Type: Individual
Name: Jason Richard Ellsworth Moore, LSW
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Social Worker
Credential: LSW
Enumeration Date: Apr 29, 2011
Last Updated: May 2, 2011

Practice Location

Address: 2233 ROCKY LN
City: Ashland
State: Ohio
ZIP Code: 44805-4701
Phone: (419) 281-3716

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Social Worker	104100000X	Primary

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