Jazmen Moore
Student in an Organized Health Care Education/Training Program in Waterbury, CT. Individual provider (NPI-1).
NPI number1982306486
StatusActive
Last updated in NPPESMar 20, 2023
Details
- NPI
- 1982306486
- Entity type
- Individual (NPI-1)
- Name
- Jazmen Moore
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Mar 20, 2023
- Certification date
- Mar 20, 2023
- Last updated
- Mar 20, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – | Yes |
Practice location
79 Beacon StWaterbury, CT 06704-3424
Phone 203-574-3311
Mailing address
141 E Main StWaterbury, CT 06702-2310
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