Individual
MRS. BERNADETTE ANN MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
611 N WAYNE ST, MILLEDGEVILLE, GA 31061-2834
(478) 254-0481
Mailing address
PO BOX 178, HARDWICK, GA 31034-0178
(478) 363-6408
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
013476
GA
Other
Enumeration date
02/08/2023
Last updated
02/08/2023
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