Individual
AMBERLY ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1247 TUSCANY DR., SUITE B-1, BRASELTON, GA 30517
(678) 465-8665
Mailing address
1247 TUSCANY DR., B-1, BRASELTON, GA 30517
(678) 465-8665
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
APC009083
GA
101YM0800X
Mental Health Counselor
Primary
LPC011633
GA
Other
Enumeration date
04/15/2018
Last updated
04/04/2022
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