| Vandevelde Moreno And Associates, Llc | |
|
601 Virginia Ave N Ste 1 Tifton GA 31794-4268 | |
| (229) 396-5507 | |
| (229) 396-5093 |
| Full Name | Vandevelde Moreno And Associates, Llc |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 601 Virginia Ave N Ste 1, Tifton, Georgia |
| Authorized Official Name and Position | Jessica Vandevelde Moreno (MARRIAGE AND FAMILY THERAPIST) |
| Authorized Official Contact | 2293925273 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Vandevelde Moreno And Associates, Llc Po Box 1089 Omega GA 31775-1089 Ph: (229) 392-5273 | Vandevelde Moreno And Associates, Llc 601 Virginia Ave N Ste 1 Tifton GA 31794-4268 Ph: (229) 396-5507 |
| NPI Number | 1356978118 |
|---|---|
| Provider Enumeration Date | 03/23/2020 |
| Last Update Date | 08/13/2021 |
| Certification Date | 02/13/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356978118 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | (* (Not Available)) | Primary |
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