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Individual

MRS. LOIS MOSS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
1 W COURT SQ, SUITE 750, DECATUR, GA 30030-2538
(770) 861-0253
(404) 494-7701
Mailing address
318 SAINT PAULS CT, STOCKBRIDGE, GA 30281-1092
(770) 861-0253
(404) 494-7701

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW005033
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
003148017B
GA
05
003152532A
GA
Enumeration date
04/24/2015
Last updated
04/24/2015
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