Individual
DONNA-LEE MIGHTY-MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
500 LANIER AVE W STE 508, FAYETTEVILLE, GA 30214-7637
(678) 489-7384
Mailing address
4877 TRIGER LN, FAIRBURN, GA 30213-2087
(678) 789-6999
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
02/02/2021
Last updated
02/02/2021
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