Individual
MS. ANGELA LESLIE ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
100 CRESCENT CENTER PKWY, SUITE 1290, TUCKER, GA 30084-7060
(770) 621-0479
(770) 621-0466
Mailing address
2561 RAINOVER CT, DECATUR, GA 30034-2264
(404) 288-3759
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC005488
GA
Other
Enumeration date
05/12/2009
Last updated
05/12/2009
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