Individual
KYLIE ELLINGTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
2845 SUMMERCREST LN, DULUTH, GA 30096-2776
(678) 271-6978
(678) 280-6766
Mailing address
2845 SUMMERCREST LN, DULUTH, GA 30096-2776
(678) 271-6978
(678) 280-6766
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT008740
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OT008740
OCCUPATIONAL THERAPY LICENSE
GA
Enumeration date
02/02/2023
Last updated
02/02/2023
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