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Individual

MRS. EBONY MARIE CAGE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
1670 CLAIRMONT RD, DECATUR, GA 30033-4004
(770) 827-9163
Mailing address
PO BOX 791, TYRONE, GA 30290-0791

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW005081
GA

Other

Enumeration date
10/07/2014
Last updated
10/07/2014
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