Individual
ELLEN FAITH CRISWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
109 MARTIN LUTHER KING JR DR, FORSYTH, GA 31029-1689
(478) 787-5790
Mailing address
477 SUNSET TER, FORSYTH, GA 31029-1678
(478) 787-5790
Taxonomy
Speciality
Code
Description
License number
State
373H00000X
Day Training/Habilitation Specialist
Primary
—
—
Other
Enumeration date
09/10/2021
Last updated
09/10/2021
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