Individual
JASMINE S MOON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1921 WHITTLESEY RD STE 400, COLUMBUS, GA 31904-9211
(706) 571-7771
Mailing address
1921 WHITTLESEY RD STE 400, COLUMBUS, GA 31904-9211
(706) 571-7771
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110026265E
—
MA
Enumeration date
12/28/2017
Last updated
04/27/2018
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