Individual
DANIELLE MOULTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2307 PROSE CIR, COVINGTON, GA 30016-1380
(678) 697-8139
Mailing address
2307 PROSE CIR, COVINGTON, GA 30016-1380
(678) 697-8139
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
GA
103TH0100X
Health Service Psychologist
—
—
251E00000X
Home Health Agency
Primary
—
GA
251E00000X
Home Health Agency
—
—
251J00000X
Nursing Care Agency
—
—
374U00000X
Home Health Aide
—
—
Other
Enumeration date
04/14/2025
Last updated
04/14/2025
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