Organization
MIMI ELLIS NUTRITION AND HEALTH COACHING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIREILLE F ELLIS PA-C, RDN (CEO)
(602) 684-4682
Entity
Organization
Contact information
Practice address
5835 LENOX PARK PL, BUFORD, GA 30518-7690
(602) 684-4682
Mailing address
5835 LENOX PARK PL, BUFORD, GA 30518-7690
(602) 684-4682
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
05/01/2023
Last updated
05/01/2023
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