Individual
FRED T MOELLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.P.C.
Contact information
Practice address
11805 NORTHFALL LANE, SUITE 804, ALPHARETTA, GA 30009
(770) 410-5788
(770) 410-4041
Mailing address
11805 NORTHFALL LANE, SUITE 804, ALPHARETTA, GA 30009
(770) 410-5788
(770) 410-4041
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2084
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
241087000
MAGELLAN BEHAVIORAL HEALT
GA
05
—
324771962A
—
GA
Enumeration date
03/12/2007
Last updated
09/23/2010
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