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1053881755
ELLIE D. MOODY
STONE MOUNTAIN, GA
NPI
1053881755
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2018-11-26
Last Update Date
2018-11-26
Business Address
ELLIE D. MOODY
2300 W PARK PL STE 135
STONE MOUNTAIN, GA 30087-3561
Phone number: 678-330-1400
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Mailing Address
ELLIE D. MOODY
215 WISTERIA DR
OXFORD, GA 30054-4040
Phone number: 678-360-0488
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