Healthcare Provider Details

I. General information

NPI: 1831076132
Provider Name (Legal Business Name): JENNIFER ERICA MOORE LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2025
Last Update Date: 08/19/2025
Certification Date: 08/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3380 RUBEN TORRES SR BLVD STE 203E
BROWNSVILLE TX
78526-2908
US

IV. Provider business mailing address

3380 RUBEN TORRES SR BLVD STE 203E
BROWNSVILLE TX
78526-2908
US

V. Phone/Fax

Practice location:
  • Phone: 956-579-2346
  • Fax:
Mailing address:
  • Phone: 956-579-2346
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number205092
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: