Individual
ELIZABETH MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MAMFT
Contact information
Practice address
1640 POWERS FERRY RD SE, BLDG 27, STE 150, MARIETTA, GA 30067-5491
(770) 715-1515
Mailing address
1640 POWERS FERRY RD SE, BLDG 27, STE 150, MARIETTA, GA 30067-5491
(770) 715-1515
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
APC003133
GA
Other
Enumeration date
12/05/2013
Last updated
12/05/2013
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