Individual
JENNIFER TUCKER MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
431 WEST PONCE DE LEON, SUITE 7, DECATUR, GA 30030
(404) 272-6922
Mailing address
1836 WESTMINSTER WAY NE, ATLANTA, GA 30307
(404) 272-6922
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW003881
GA
Other
Enumeration date
03/03/2008
Last updated
03/03/2008
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