Individual
MARTIA MOFFETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
62 OLD AIRPORT RD, HATTIESBURG, MS 39401-8382
(601) 544-4550
(601) 582-3373
Mailing address
PO BOX 1729, HATTIESBURG, MS 39403-1729
(601) 545-8700
(601) 450-2493
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
C3718
MS
Other
Enumeration date
10/05/2017
Last updated
10/05/2017
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