Individual
MR. JOHN MICHAEL MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAPC
Contact information
Practice address
3643 WALTON WAY EXT, BLDG, AUGUSTA, GA 30909-4507
(706) 421-6039
Mailing address
3643 WALTON WAY EXT, BLDG, AUGUSTA, GA 30909-4507
(706) 421-6039
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
APC002693
GA
Other
Enumeration date
03/02/2012
Last updated
03/02/2012
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