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Jason Wade Moore, CPS
Peer Specialist in Wentzville, Missouri
NPI 1487266011

Jason Wade Moore is a Peer Specialist based in Wentzville, MO. Jason Wade Moore practices in Wentzville, MO and has the professional credentials of CPS. The NPI Number for Jason Wade Moore is 1487266011 and holds a License No. 12611 (Missouri).

The current practice location address for Jason Wade Moore is 5 West Pearce Boulevard, Wentzville, MO and can be reached out via phone at 636-344-6572. You can also correspond with Jason Wade Moore through the mailing address at 312 PLEASANT MEADOWS DRIVE, WENTZVILLE, MO - 63385 (mailing address contact number: 636-344-6572).

Location: 5 West Pearce Boulevard, Wentzville, MO, 63385
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1487266011
Provider Name
Jason Wade Moore
Credential
CPS
Provider Entity Type
Individual
Gender
Male
Address
5 West Pearce Boulevard, Wentzville, MO, 63385
Phone Number
636-344-6572
Fax Number
Provider Enumeration Date
08/17/2020
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
5 West Pearce Boulevard
City
Wentzville
State
Missouri
Zip
63385
Phone Number
636-344-6572
Fax Number
person
Provider Business Mailing Address Details
Address
312 Pleasant Meadows Drive
City
Wentzville
State
Missouri
Zip
63385
Phone Number
636-344-6572
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Peer Specialist
Speciality
-
Taxonomy
175T00000X
License No.
12611 (Missouri)
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
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