| Jaclyn Mouras, Psyd, Pllc | |
|
27 Stoneridge Dr Ste A01 Waynesboro VA 22980-6583 | |
| (540) 221-1846 | |
| Not Available |
| Full Name | Jaclyn Mouras, Psyd, Pllc |
|---|---|
| Speciality | Clinical Neuropsychologist |
| Location | 27 Stoneridge Dr Ste A01, Waynesboro, Virginia |
| Authorized Official Name and Position | Jaclyn Mouras (MANAGING CONTROL) |
| Authorized Official Contact | 4848834923 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jaclyn Mouras, Psyd, Pllc 81 Broad St Harrisonburg VA 22802-4119 Ph: () - | Jaclyn Mouras, Psyd, Pllc 27 Stoneridge Dr Ste A01 Waynesboro VA 22980-6583 Ph: (540) 221-1846 |
| NPI Number | 1467173971 |
|---|---|
| Provider Enumeration Date | 09/05/2022 |
| Last Update Date | 09/05/2022 |
| Certification Date | 09/04/2022 |
| Medicare PECOS PAC ID | 2163807652 |
|---|---|
| Medicare Enrollment ID | O20220920001692 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467173971 | NPI | - | NPPES |
| 1639805708 | Other | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103G00000X | Clinical Neuropsychologist | (* (Not Available)) | Primary |
| Provider Name | Jaclyn Mouras |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1639805708 PECOS PAC ID: 7113302613 Enrollment ID: I20220920001984 |
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