Organization
PSYCHOLOGY AND COUNSELING CENTERS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM B MOON PHD (OWNER)
(770) 386-8996
Entity
Organization
Contact information
Practice address
17 FELTON PL, SUITE A, CARTERSVILLE, GA 30120-2153
(770) 386-8996
(770) 386-8100
Mailing address
17 FELTON PL, SUITE A, CARTERSVILLE, GA 30120-2153
(770) 386-8996
(770) 386-8100
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY001063
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000418371F
—
GA
Enumeration date
09/22/2009
Last updated
09/22/2009
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