NPI 1013400068

Gabrielle a Ellis, RBT

Practitioner Behavior Technician Edwardsville, IL

Practice location

Address: 115 Rottingham CT STE a, Edwardsville, IL 62025-3677
Phone: (866) 522-2467
Fax: (217) 789-1420
Mailing address: 5220 6th Street Frontage Rd E STE 1700, Springfield, IL 62703-5771

Registered specialties

Behavior Technician Primary

Behavioral Health & Social Service Providers Taxonomy 106S00000X

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Registry record

NPI: 1013400068
Entity type: Individual
Sex (as registered): Female
NPI issued: 13 Jun 2018
Record last updated: 13 Jun 2018

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.