Individual
ELLIE MORGAN GRAY POWNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
115 N PARK TRL STE 123, STOCKBRIDGE, GA 30281-7373
(888) 509-6368
Mailing address
175 MIDDLE ST UNIT 1201, LAKE MARY, FL 32746-3625
(866) 610-0580
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
05/12/2021
Last updated
05/12/2021
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