Jerry Wayne Moore, THERAPUTIC MENTOR
NPI #1174805741 in Haverhill, Massachusetts
Provider Information
- NPI Number
- 1174805741
- Entity Type
- Individual
- Name
- Jerry Wayne Moore, THERAPUTIC MENTOR
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Social Worker
- Credential
- THERAPUTIC MENTOR
- Enumeration Date
- Sep 9, 2011
- Last Updated
- Sep 9, 2011
Practice Location
- Address
- 60 MERRIMAC ST
- City
- Haverhill
- State
- Massachusetts
- ZIP Code
- 01830-6207
- Phone
- (978) 373-1126
Specialties & Taxonomy Codes
| Specialty |
|---|
| Social Worker |
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