Individual
MS. KEVA ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
6815 W FAYETTEVILLE RD, RIVERDALE, GA 30296-2528
(281) 236-6762
Mailing address
6815 W FAYETTEVILLE RD, RIVERDALE, GA 30296-2528
(907) 984-2477
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC010433
GA
Other
Enumeration date
07/09/2020
Last updated
06/27/2022
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