Individual
JACKQUELINE DENISE MOSES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2100 COMER AVE, COLUMBUS, GA 31904-8725
(678) 836-9390
Mailing address
2100 COMER AVE, COLUMBUS, GA 31904-8725
(678) 836-9390
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
03/20/2023
Last updated
03/20/2023
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