MEDICARE: MRS. JENNIFER KAISER MOSES M.S., L.P.C.

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
1	101YP2500X	Professional Counselor	5024	NC

General Provider Information

NPI Number	:	1710010855
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JENNIFER KAISER MOSES M.S., L.P.C.

Provider Business Mailing Address
First Line	:	509 RED FOX CT
Second Line	:
City	:	HAVELOCK
State	:	NC
Zip	:	28532-2368
Country	:	US
Telephone Number	:	252-447-2575
Fax Number	:

Provider Business Practice Location Address
First Line	:	2117 S GLENBURNIE RD
Second Line	:	SUITE 17, 18
City	:	NEW BERN
State	:	NC
Zip	:	28562-2239
Country	:	US
Telephone Number	:	252-633-3855
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/14/2007
Last Update Date	:	07/08/2007

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