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Individual

KRISTEN M ELLISON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
125 SAMARITAN DR, CUMMING, GA 30040-2354
(352) 356-1603
Mailing address
801 CREST PARK PT, GAINESVILLE, GA 30504-2699
(352) 356-1603

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT006789
GA

Other

Enumeration date
11/25/2018
Last updated
11/25/2018
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