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Martin Moore JR.
Mental Health Counselor in Hattiesburg, Mississippi
NPI 1720745813

Martin Moore JR. is a Mental Health Counselor based in Hattiesburg, MS and is specialized in Mental Health. Martin Moore JR. practices in Hattiesburg, MS. The NPI Number for Martin Moore JR. is 1720745813 and holds a License No. M9920 (Mississippi).

The current practice location address for Martin Moore JR. is 103 S 19Th Ave, Hattiesburg, MS and can be reached out via phone at 601-544-4641 and via fax at 604-582-1607.

Location: 103 S 19Th Ave, Hattiesburg, MS, 39404-8679
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1720745813
Provider Name
Martin Moore JR.
Credential
Provider Entity Type
Individual
Gender
Male
Address
103 S 19Th Ave, Hattiesburg, MS, 39404-8679
Phone Number
601-544-4641
Fax Number
604-582-1607
Provider Enumeration Date
11/23/2021
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
103 S 19Th Ave
City
Hattiesburg
State
Mississippi
Zip
39401-6171
Phone Number
601-544-4641
Fax Number
604-582-1607
person
Provider Business Mailing Address Details
Address
103 S 19Th Ave
City
Hattiesburg
State
Mississippi
Zip
39401-6171
Phone Number
601-544-4641
Fax Number
604-582-1607
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
101YM0800X
License No.
M9920 (Mississippi)
Definition
Definition to come...
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