Doctor Name: | JESSICA MORELAND |
NPI Number: | 1063817526 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MSW CANDIDATE |
License Number: | |
Business Practice Address: | 710 N Taylor St Gunnison, CO - 812302244 |
Business Phone Number: | 9706410229 |
Business Fax Number: | 9706412949 |
Mailing Address: | Po Box 1208, MONTROSE |
State: | CO |
Postal Code: | 814021208 |
Phone Number: | 9702523200 |
Fax Number: | 9702523208 |
NPI Enumeration Date: | 10/27/2014 |
NPI Last Update Date: | 10/27/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |