Individual
KENYADA MOSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
762 THURMOND DR., MACON, GA 31204
(770) 570-0595
Mailing address
762 THURMOND DR, MACON, GA 31204-1753
(770) 570-0595
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
GA
Other
Enumeration date
07/19/2017
Last updated
07/21/2022
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