Individual
LISA MOONEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
48 TAYLOR VALLEY RD, CLAYTON, GA 30525-5815
(706) 490-2667
(706) 782-1272
Mailing address
PO BOX 458, TIGER, GA 30576-0458
(706) 490-2667
(706) 782-1272
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
06/29/2007
Last updated
07/08/2007
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