Individual
ANDRE JAMAL ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4861 WILLIAMS DR STE 101, GEORGETOWN, TX 78633-2425
(737) 295-4536
Mailing address
5850 GRANITE PKWY STE 600, PLANO, TX 75024-6753
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
07/31/2023
Last updated
07/31/2023
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