Provider Demographics
NPI:1831573609
Name:MOE, JESSICA E (PSYD)
Entity type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:E
Last Name:MOE
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9121 N MILITARY TRL STE 207
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410-5988
Mailing Address - Country:US
Mailing Address - Phone:561-935-8905
Mailing Address - Fax:
Practice Address - Street 1:9121 N MILITARY TRL
Practice Address - Street 2:SUITE 207
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-5984
Practice Address - Country:US
Practice Address - Phone:561-935-8905
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-12
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY9142103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist