Organization
GENESIS BEHAVIORAL HEALTH SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHANNON MONIQUE MOORE PHD (MANAGER)
(769) 524-4578
Entity
Organization
Contact information
Practice address
357 TOWNE CENTER PL STE 200, RIDGELAND, MS 39157-4837
(769) 524-4578
(769) 524-4630
Mailing address
PO BOX 1956, MADISON, MS 39130-1956
(769) 524-4578
(769) 524-4630
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Enumeration date
08/14/2020
Last updated
08/14/2020
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