Individual
MAZIE DOUGLAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1918 PANOLA RD, LITHONIA, GA 30058-5520
(404) 597-2203
Mailing address
1918 PANOLA RD, LITHONIA, GA 30058-5520
(404) 597-2203
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
311ZA0620X
Adult Care Home Facility
—
—
Other
Enumeration date
02/08/2024
Last updated
02/08/2024
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