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1518599729
DAKTOA JACK FIDRAM
ATLANTA, GA
NPI
1518599729
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: GA APC007221)
Enumeration Date
2020-02-05
Last Update Date
2020-02-05
Business Address
DAKTOA JACK FIDRAM APC
2302 PARKLAKE DR NE STE 425
ATLANTA, GA 30345-2896
Phone number: 678-400-4441
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Mailing Address
DAKTOA JACK FIDRAM APC
2302 PARKLAKE DR NE STE 425
ATLANTA, GA 30345-2896
Phone number: 678-400-4441
Copy
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