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1982018370
STACY L WILLIS
AUGUSTA, GA
NPI
1982018370
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
(Licence: GA LCB201400000776)
Enumeration Date
2014-06-13
Last Update Date
2014-06-13
Business Address
-- STACY L WILLIS BS
1007 CADDENWOODS DR
AUGUSTA, GA 30906-5618
Phone number: 706-751-4089
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Mailing Address
-- STACY L WILLIS BS
1007 CADDENWOODS DR
AUGUSTA, GA 30906-5618
Phone number: 706-751-4089
Copy
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