Individual
JUSTIN MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMFT
Contact information
Practice address
2704 N OAK ST BLDG J, VALDOSTA, GA 31602-1768
(229) 262-7333
(229) 262-7335
Mailing address
2704 N OAK ST BLDG J, VALDOSTA, GA 31602-1768
(229) 262-7333
(229) 262-7335
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
MFT001759
GA
171W00000X
Contractor
—
—
Other
Enumeration date
06/14/2017
Last updated
02/21/2023
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