Provider Demographics
NPI:1902615099
Name:MOYER, JASMIN MONET
Entity type:Individual
Prefix:
First Name:JASMIN
Middle Name:MONET
Last Name:MOYER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1426 GUILFORD PL
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19122-3412
Mailing Address - Country:US
Mailing Address - Phone:215-410-6129
Mailing Address - Fax:
Practice Address - Street 1:4455 N 6TH ST STE 100
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19140-2319
Practice Address - Country:US
Practice Address - Phone:215-205-5157
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-02
Last Update Date:2025-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health