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NPI Code Detail

MEDICARE: JENNIFER MORAN MA

MEDICARE:   JENNIFER  MORAN  MA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1639914021
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER MORAN MA
Provider Business Mailing Address
First Line : 43 BETHANY LN
Second Line :
City : NORTH KINGSTOWN
State : RI
Zip : 02852-1304
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 140 POINT JUDITH RD # 23
Second Line :
City : NARRAGANSETT
State : RI
Zip : 02882-3477
Country : US
Telephone Number : 401-250-2731
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/27/2024
Last Update Date : 06/27/2024

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Directions to “ JENNIFER MORAN MA” Practice Location

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