Individual
HARRIET D MOODY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4367 NEW SNAPFINGER WOODS DR, DECATUR, GA 30035-2920
(770) 981-2008
(770) 981-6302
Mailing address
4367 NEW SNAPFINGER WOODS DR, DECATUR, GA 30035-2920
(770) 981-2008
(770) 981-6302
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
003716
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
583231074A
—
GA
Enumeration date
09/15/2006
Last updated
05/10/2021
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