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Organization
LIVING FULLY PSYCHOTHERAPY AND CONSULTING, LLC
Active
Organization
LIVING FULLY PSYCHOTHERAPY AND CONSULTING, LLC
Active
Other names
Living Fully
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PEGAH MOGHADDAM PSY.D. (OWNER/DIRECTOR)
(678) 591-9117
Entity
Organization
Contact information
Practice address
1463 OXFORD RD NE, ATLANTA, GA 30322-1046
(678) 591-9117
Mailing address
553 COBBLESTONE TRL, AVONDALE ESTATES, GA 30002-1211
(678) 591-9117
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
PSY003405
GA
Other
Enumeration date
12/20/2013
Last updated
12/20/2013
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