Individual
ELLEN DONALDSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4061 SUZANNE DR STE CANDD, DIBERVILLE, MS 39540-3735
(228) 396-4434
Mailing address
104 VICKSBURG CT, OCEAN SPRINGS, MS 39564-5934
(228) 218-1027
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
01/06/2022
Last updated
01/06/2022
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