Individual
ANTONIO MOODY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
7474 GREENBELT CENTER DRIVE, GREENBELT, MD 20770
(240) 304-3327
Mailing address
47 BARBERRY CT, UPPER MARLBORO, MD 20774-1650
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LGP9282
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101YP2500X
—
MD
Enumeration date
07/25/2019
Last updated
07/25/2019
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