Most Relevant Information
Provider Data
| NPI Number: | 1003524729 |
| Provider Name: | JULIANA MOORE |
| Entity Type: | Individual |
| Taxonomy Code: | 101YM0800X |
| Specialty: | Counselor |
| License Number: | 6451022464 |
Most Important Dates
| Enumeration Date: | 11/10/2022 |
| Last Updated: | 11/10/2022 |
Provider Practice Location
437 FERN AVE
JACKSON
MI
492023970
Practice Location Phone/Fax
| Phone: | 5172472033 |
| Fax: |
Provider Mailing Location
600 HARWOOD ST
JACKSON
MI
492033016
Provider Mailing Phone/Fax
| Phone: | 5179143935 |
| Fax: |