Individual
MRS. TIKIMA WILLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
985 MOUNT ZION RD APT 32B, MORROW, GA 30260-2293
(313) 502-3451
Mailing address
985 MOUNT ZION RD APT 32B, MORROW, GA 30260-2293
(313) 502-3451
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
—
GA
Other
Enumeration date
03/12/2021
Last updated
03/12/2021
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