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Individual

MR. JERRY MARK MOTT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.S.

Contact information

Practice address
3510 MONTLIMAR PLAZA DR STE 100, MOBILE, AL 36609-1746
(251) 380-0215
Mailing address
1140 SHILOH CT, MOBILE, AL 36609-3069
(251) 380-0215

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
1557
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1557
LICENSED PROFESSIONAL COUNSELOR
AL
Enumeration date
07/13/2012
Last updated
09/27/2023
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