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1720745813
MARTIN MOORE
HATTIESBURG, MS
NPI
1720745813
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: MS M9920)
Enumeration Date
2021-11-23
Last Update Date
2021-11-23
Business Address
MARTIN MOORE
103 S 19TH AVE
HATTIESBURG, MS 39401-6171
Phone number: 601-544-4641
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Mailing Address
MARTIN MOORE
PO BOX 18679
HATTIESBURG, MS 39404-8679
Phone number: 601-705-1901
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