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Contact Information

DANIELLE MOULTON
2307 PROSE CIR
COVINGTON, GA30016-1380
 Phone: 678-697-8139
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Home Health

251E00000X A4[11] Home Health Agency
 

Health Service

103TH0100X 62 Psychologist, Clinical
 

Home Health Aide

374U00000X
 

Mental Health

101YM0800X
 

Nursing Care

251J00000X
Indicates primary specialty

NPI Profile & details for

NPI Number 1619762358
Entity Organization
Organization subpart 1 Not specified
Enumeration date 04/14/2025
Last updated 04/14/2025 - More than a year ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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