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1124861604
IRISS MICKENS
DECATUR, GA
NPI
1124861604
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101Y00000X Counselor
(Licence: GA MSW009542)
Enumeration Date
2024-06-13
Last Update Date
2024-06-13
Business Address
IRISS MICKENS LMSW
455 WINN WAY
DECATUR, GA 30030-1707
Phone number: 404-508-6430
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Mailing Address
IRISS MICKENS LMSW
445 WINN WAY
DECATUR, GA 30030-1707
Phone number: 404-294-3835
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