Individual
SALITHIA KEIANA MCDUFFIE-MOON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
811 CHATTAHOOCHEE CIR, ROSWELL, GA 30075-5109
(470) 791-6969
Mailing address
811 CHATTAHOOCHEE CIR, ROSWELL, GA 30075-5109
(470) 791-6969
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CO124536
MASTER COSMETOLOGIST
GA
Enumeration date
06/12/2022
Last updated
06/12/2022
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