Organization
DEAF ACCESS TO QUALITY LIFE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MAKOTO IKEGAMI I DSW, LCSW, MSW (CEO/PRESIDENT)
(215) 987-2730
Entity
Organization
Contact information
Practice address
1901 ROSEWOOD RD, DECATUR, GA 30032-7017
(215) 987-2730
Mailing address
1901 ROSEWOOD RD, DECATUR, GA 30032-7017
(215) 987-2730
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
05/29/2020
Last updated
12/21/2023
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