Individual
ALISHA ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CSW
Contact information
Practice address
416 SWEET BAY LN, DALLAS, GA 30132-5108
(917) 969-8578
Mailing address
416 SWEET BAY LN, DALLAS, GA 30132-5108
(917) 969-8578
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
079516
NY
1041C0700X
Clinical Social Worker
CSW006601
GA
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
08/19/2024
Last updated
08/19/2024
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