Individual
DR. MAKOTO IKEGAMI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DSW, MSW, LCSW
Contact information
Practice address
1901 ROSEWOOD RD, DECATUR, GA 30032-7017
(470) 763-5282
Mailing address
1901 ROSEWOOD RD, DECATUR, GA 30032-7017
(470) 763-5282
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW006447
GA
1041C0700X
Clinical Social Worker
CW017519
PA
1041C0700X
Clinical Social Worker
SW14355
FL
Other
Enumeration date
03/06/2012
Last updated
01/09/2024
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