Kevin Jewayne Moore
NPI #1710551510 in Benton Harbor, Michigan
Provider Information
- NPI Number
- 1710551510
- Entity Type
- Individual
- Name
- Kevin Jewayne Moore
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Counselor - Addiction (Substance Use Disorder)
- Enumeration Date
- May 17, 2021
- Last Updated
- May 17, 2021
Practice Location
- Address
- 1485 M 139
- City
- Benton Harbor
- State
- Michigan
- ZIP Code
- 49022-5711
- Phone
- (269) 925-0585
Specialties & Taxonomy Codes
| Specialty |
|---|
| Counselor - Addiction (Substance Use Disorder) — Addiction (Substance Use Disorder) |
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