Individual
MR. RENE J ELY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMFT
Contact information
Practice address
1790 CENTURY BLVD NE STE A, ATLANTA, GA 30345-3322
(404) 671-9226
(770) 978-7676
Mailing address
PO BOX 1218, SNELLVILLE, GA 30078-1218
(678) 520-7476
(770) 978-7676
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
MFT000908
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
799255930A
—
GA
Enumeration date
02/06/2007
Last updated
01/17/2024
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