Individual
DR. ELLEN S. BRACKUP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
1251 APPLE VALLEY RD NE, ATLANTA, GA 30319-5424
(404) 231-4455
Mailing address
1251 APPLE VALLEY RD NE, ATLANTA, GA 30319-5424
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
697
GA
103TC0700X
Clinical Psychologist
697
GA
Other
Enumeration date
04/02/2007
Last updated
09/11/2025
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