Individual
ELLEN FARRELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
415 BONAVENTURE RD, THUNDERBOLT, GA 31404-3299
(912) 247-4263
Mailing address
105 WILLOW POINT CIR, POOLER, GA 31322-3925
(912) 247-4263
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC004218
GA
Other
Enumeration date
11/05/2009
Last updated
11/05/2009
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