Individual
STEPHANIE MOSES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1465 LAKELAND DR, JACKSON, MS 39216-4719
(601) 352-7784
Mailing address
1335 STANTON DR, JACKSON, MS 39211-4223
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
—
MS
Other
Enumeration date
04/04/2019
Last updated
06/07/2019
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