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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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