Individual
JUANESE MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
4500 HUGH HOWELL RD STE 620D, TUCKER, GA 30084-4720
(770) 609-7288
(470) 777-2790
Mailing address
375 ROCKBRIDGE RD NW STE 172-350, LILBURN, GA 30047-8225
(770) 609-7288
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC010471
GA
Other
Enumeration date
09/18/2018
Last updated
03/25/2021
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