Individual
JACQUELINE C ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
415 N JACKSON ST, P.O. DRAWER 1348, AMERICUS, GA 31709-3015
(229) 931-2470
(229) 931-2474
Mailing address
415 N JACKSON ST, P.O. DRAWER 1348, AMERICUS, GA 31709-3015
(229) 931-2470
(229) 931-2474
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC004305
GA
Other
Enumeration date
03/26/2008
Last updated
03/26/2008
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