Most Relevant Information
Provider Data
| NPI Number: | 1003361411 |
| Provider Name: | JENNIE MORAN |
| Entity Type: | Individual |
| Taxonomy Code: | 171M00000X |
| Specialty: | Case Manager/Care Coordinator |
| License Number: |
Most Important Dates
| Enumeration Date: | 08/16/2016 |
| Last Updated: | 08/16/2016 |
Provider Practice Location
1516 ATWOOD AVE
JOHNSTON
RI
029193223
Practice Location Phone/Fax
| Phone: | 4017852666 |
| Fax: | 4017852272 |
Provider Mailing Location
1516 ATWOOD AVE
JOHNSTON
RI
029193223
Provider Mailing Phone/Fax
| Phone: | 4017852666 |
| Fax: | 4017852272 |