| Nathalie Ellis, Llc | |
|
2855 Candler Rd Suite 9 Decatur GA 30034-1415 | |
| (678) 732-7269 | |
| (678) 601-2928 |
| Full Name | Nathalie Ellis, Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 2855 Candler Rd, Decatur, Georgia |
| Authorized Official Name and Position | Nathalie D Ellis (OWNER) |
| Authorized Official Contact | 6787327269 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Nathalie Ellis, Llc 3153 Oxbridge Way Lithonia GA 30038-2228 Ph: (678) 732-7269 | Nathalie Ellis, Llc 2855 Candler Rd Suite 9 Decatur GA 30034-1415 Ph: (678) 732-7269 |
| NPI Number | 1700132099 |
|---|---|
| Provider Enumeration Date | 07/24/2012 |
| Last Update Date | 07/24/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700132099 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | LPC004352 (Georgia) | Primary |
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