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Organization
VANDEVELDE MORENO AND ASSOCIATES, LLC
Active
Organization
VANDEVELDE MORENO AND ASSOCIATES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA VANDEVELDE MORENO LMFT (MARRIAGE AND FAMILY THERAPIST)
(229) 392-5273
Entity
Organization
Contact information
Practice address
601 VIRGINIA AVE N STE 1, TIFTON, GA 31794-4268
(229) 396-5507
(229) 396-5093
Mailing address
PO BOX 1089, OMEGA, GA 31775-1089
(229) 392-5273
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
—
NULL
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Enumeration date
03/23/2020
Last updated
08/13/2021
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