Individual
MRS. SELINA Y ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2055 GEES MILL RD NE, SUITE 327, CONYERS, GA 30013-1362
(770) 679-5714
(888) 273-6606
Mailing address
PO BOX 81314, CONYERS, GA 30013-9314
(770) 679-5714
(888) 273-6606
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
—
GA
3747A0650X
Attendant Care Provider
—
—
376K00000X
Nurse's Aide
Primary
—
GA
Other
Enumeration date
01/16/2011
Last updated
09/26/2012
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