MR. Jackie Moore, MA
NPI #1629355870 in Grosse Pointe, Michigan
Provider Information
- NPI Number
- 1629355870
- Entity Type
- Individual
- Name
- MR. Jackie Moore, MA
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Counselor - Addiction (Substance Use Disorder)
- Credential
- MA
- Enumeration Date
- Nov 15, 2011
- Last Updated
- Nov 15, 2011
Practice Location
- Address
- 18530 MACK AVE STE 101
- City
- Grosse Pointe
- State
- Michigan
- ZIP Code
- 48236-3254
- Phone
- (313) 673-9073
Specialties & Taxonomy Codes
| Specialty |
|---|
| Counselor - Addiction (Substance Use Disorder) — Addiction (Substance Use Disorder) |
| Psychologist - Counseling — Counseling |
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