Individual
ELIZABETH MOONEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1414 DUG GAP RD, DALTON, GA 30720-5007
(706) 279-0405
Mailing address
1414 DUG GAP RD, DALTON, GA 30720-5007
(706) 279-0405
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1770627515
—
GA
Enumeration date
04/09/2019
Last updated
04/09/2019
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