Individual
ELLA LAN TRAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1155 CONCORD RD SE STE 220, SMYRNA, GA 30080-4255
(470) 666-2550
Mailing address
1155 CONCORD RD SE STE 220, SMYRNA, GA 30080-4255
(470) 666-2550
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
BACB1223700
GA
Other
Enumeration date
02/18/2025
Last updated
02/18/2025
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