Individual
KAYLA MOULTRIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1030 FAYETTEVILLE RD SE, ATLANTA, GA 30316-2921
(404) 817-6463
Mailing address
3310 MERRICK DR, PEACHTREE CITY, GA 30269-6664
(470) 202-8839
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1134257827
—
GA
Enumeration date
09/15/2021
Last updated
09/15/2021
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