Organization
VANDEVELDE MORENO AND ASSOCIATES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA VANDEVELDE MORENO LMFT (MARRIAGE AND FAMILY THERAPIST)
(229) 392-5273
Entity
Organization
Contact information
Practice address
601 VIRGINIA AVE N STE 1, TIFTON, GA 31794-4268
(229) 396-5507
(229) 396-5093
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
03/23/2020
Last updated
08/13/2021
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