Individual
MS. LOUISA CARNS ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1550 CAMELOT CIR, TUCKER, GA 30084-7703
(508) 725-0125
(508) 725-0125
Mailing address
1550 CAMELOT CIR, TUCKER, GA 30084-7703
(508) 725-0125
(508) 725-0125
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
1021968
MA
1041C0700X
Clinical Social Worker
Primary
CSW004441
GA
Other
Enumeration date
07/12/2012
Last updated
07/12/2012
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