| Teah L. Moore | |
|
733b Carroll St Perry GA 31069-3368 | |
| (423) 943-7754 | |
| Not Available |
| Full Name | Teah L. Moore |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 733b Carroll St, Perry, Georgia |
| Authorized Official Name and Position | Teah Lynette Moore (OWNER/LICENSED PROFESSIONAL COUNSEL) |
| Authorized Official Contact | 4239437754 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Teah L. Moore 312 Shane Cir Perry GA 31069-3776 Ph: (423) 943-7754 | Teah L. Moore 733b Carroll St Perry GA 31069-3368 Ph: (423) 943-7754 |
| NPI Number | 1508381344 |
|---|---|
| Provider Enumeration Date | 08/12/2017 |
| Last Update Date | 08/12/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508381344 | NPI | - | NPPES |
| 003181539A | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 0006549 (Georgia) | Primary |
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