Organization
THE DAMASCUS ROAD
Active
Other names
Teah L. Moore
Organization subpart
No
Provider details
NPI number
Authorized official
TEAH LYNETTE MOORE PHD, LPC (OWNER/LICENSED PROFESSIONAL COUNSEL)
(423) 943-7754
Entity
Organization
Contact information
Practice address
733B CARROLL ST, PERRY, GA 31069-3368
(423) 943-7754
Mailing address
312 SHANE CIR, PERRY, GA 31069-3776
(423) 943-7754
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
0006549
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003181539A
—
GA
Enumeration date
08/12/2017
Last updated
08/12/2017
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