Individual
JENNIFER MOODY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
690 COURTENAY DR NE, ATLANTA, GA 30306-3421
(404) 875-4551
Mailing address
1992 FOSCO DR, DULUTH, GA 30097-4806
(678) 421-8158
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
MSW010604
GA
Other
Enumeration date
04/22/2022
Last updated
04/22/2022
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