Individual
JESSICA VANDEVELDE MORENO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
601 VIRGINIA AVE N STE 1, TIFTON, GA 31794-4268
(229) 233-7992
Mailing address
PO BOX 1089, OMEGA, GA 31775-1089
(229) 392-5273
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Enumeration date
08/23/2017
Last updated
02/13/2021
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