Individual
OLIVIA KATHLEEN ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
14557 US 19 SUITE C, GRIFFIN, GA 30224
(770) 468-6941
Mailing address
314 CHEROKEE RD, THOMASTON, GA 30286-4037
(706) 594-0280
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-26-88966
GA
Other
Enumeration date
04/14/2026
Last updated
04/14/2026
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