Individual
MOSES U IZEVBIGIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5909 PROVIDENCE RUN, UNION CITY, GA 30291-6112
(404) 277-4596
Mailing address
5909 PROVIDENCE RUN, UNION CITY, GA 30291-6112
(404) 277-4596
Taxonomy
Speciality
Code
Description
License number
State
103TM1800X
Intellectual & Developmental Disabilities Psychologist
Primary
—
—
Other
Enumeration date
05/10/2023
Last updated
05/10/2023
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