Individual
JANIE ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
985 BRUTON CT SW, MARIETTA, GA 30064-2971
(770) 823-6072
Mailing address
3110 HAWKS CT, STATESBORO, GA 30461-4218
(770) 823-6072
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-23-64449
GA
Other
Enumeration date
03/06/2023
Last updated
03/06/2023
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