Individual
DR. ELIZABETH MYRNA ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
801 AMSTERDAM AVE NE, ATLANTA, GA 30306-3403
(770) 337-9446
(770) 476-0377
Mailing address
801 AMSTERDAM AVE NE, ATLANTA, GA 30306-3403
(770) 337-9446
(770) 476-0377
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
521
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00196171B
—
GA
Enumeration date
01/03/2007
Last updated
08/07/2023
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