Jerry R Moore, LPC, LICDC
NPI #1558845743 in Marysville, Ohio
Provider Information
- NPI Number
- 1558845743
- Entity Type
- Individual
- Name
- Jerry R Moore, LPC, LICDC
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Counselor
- Credential
- LPC, LICDC
- Enumeration Date
- Sep 24, 2018
- Last Updated
- Sep 24, 2018
Practice Location
- Address
- 16000 HUNTERS RUN
- City
- Marysville
- State
- Ohio
- ZIP Code
- 43040-9659
- Phone
- (614) 582-1081
Specialties & Taxonomy Codes
| Specialty |
|---|
| Counselor |
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