Individual
EZKIEL OMARI KHALAF ANDREWS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CAC
Contact information
Practice address
207 PINE TREE CIR, DECATUR, GA 30032-1147
(470) 640-5698
Mailing address
207 PINE TREE CIR, DECATUR, GA 30032-1147
(470) 640-5698
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
3419
GA
101YM0800X
Mental Health Counselor
Primary
LPC015169
GA
Other
Enumeration date
07/17/2017
Last updated
01/06/2025
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