NPI 1831691781

Esther Ellison

Practitioner Contractor Stone Mountain, GA

Practice location

Address: 540 Old Front St APT 12, Stone Mountain, GA 30083-3340
Phone: (347) 352-1450

Registered specialties

Contractor Primary

Other Service Providers Taxonomy 171W00000X Licence AMFT000521 (GA)

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Registry record

NPI: 1831691781
Entity type: Individual
Sex (as registered): Female
NPI issued: 7 Mar 2018
Record last updated: 7 Mar 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.