Individual
MRS. MARY LINDA ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.P.C.
Contact information
Practice address
2070 BUFORD HWY, STE 2-D, BUFORD, GA 30518-6079
(770) 271-9442
(770) 271-8939
Mailing address
6120 MAPPERLEY LN, CUMMING, GA 30041-6176
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
003585
GA
Other
Enumeration date
01/08/2007
Last updated
07/08/2007
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