Individual
MICAH MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
732 KENNESAW AVE NW STE 250, MARIETTA, GA 30060-9420
(678) 587-8858
Mailing address
732 KENNESAW AVE NW STE 250, MARIETTA, GA 30060-9420
(678) 587-8858
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
05/06/2024
Last updated
05/06/2024
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