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1871130096
MARK LOREN KIEFER
DECATUR, GA
NPI
1871130096
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: GA CSW002585)
Enumeration Date
2019-12-06
Last Update Date
2019-12-06
Business Address
MARK LOREN KIEFER
2719 MOUNT OLIVE DR
DECATUR, GA 30033-2928
Phone number: 404-660-9180
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Mailing Address
MARK LOREN KIEFER
2719 MOUNT OLIVE DR
DECATUR, GA 30033-2928
Phone number: 404-660-9180
Copy
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