Individual
ELLIS SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1522 CHIPPEWA ST, NEW ORLEANS, LA 70130-4513
(985) 446-6833
(985) 446-6835
Mailing address
1301 SAINT MARY ST, THIBODAUX, LA 70301-6527
(985) 446-6833
(985) 446-6835
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
L-782
LA
Other
Enumeration date
10/17/2023
Last updated
10/17/2023
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