Individual provider · Type 1 NPI
Dorian Ellis
Professional Counselor · Atlanta, GA
NPI number
1912522582
Active
Practice location
5470 Lemoyne Dr SW
Atlanta, GA 30331-9206
Mailing address
3645 Marketplace Blvd Ste 130-171
Atlanta, GA 30344-5747
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Professional Counselor Primary | 101YP2500X | 007688 (GA) |
Professional Counselor: Definition to come...
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About NPI 1912522582
Dorian Ellis's National Provider Identifier is 1912522582, issued on Jun 10, 2020. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Atlanta, GA. The record was last updated on Jun 10, 2020.