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Individual

MOYA GRANT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
NCC, LAPC

Contact information

Practice address
11201 JEFFERSON CIR N, ATLANTA, GA 30341-2690
(678) 487-9763
Mailing address
3675 MARKETPLACE BLVD # 1173, EAST POINT, GA 30344-5730
(678) 487-9763

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC014371
GA

Other

Enumeration date
03/08/2023
Last updated
01/16/2025
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