Individual
DR. STEPHANIE L. EZUST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
317 W HILL ST, SUITE 101, DECATUR, GA 30030-4319
(404) 371-9171
(404) 371-9172
Mailing address
PO BOX 1192, DECATUR, GA 30031-1192
(404) 371-9171
(404) 371-9172
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1513
GA
Other
Enumeration date
01/02/2007
Last updated
09/27/2016
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