Individual
KINGSLEY EZEMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
421 12TH ST, COLUMBUS, GA 31901-2522
(706) 494-7776
(706) 494-7076
Mailing address
4800 BURT MAR DR, APT. F3, COLUMBUS, GA 31907-9570
(706) 615-8317
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
09/07/2008
Last updated
09/07/2008
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