Individual
AMBER NICOLE ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
3771 STEFANI RD, CANTONMENT, FL 32533-7795
(850) 607-6910
(850) 607-6932
Mailing address
3771 STEFANI RD, CANTONMENT, FL 32533-7795
(850) 607-6910
(850) 607-6932
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-1982768
GA
Other
Enumeration date
04/22/2019
Last updated
04/22/2019
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