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1053054262
TAMICIA DESTINY ELLISON
LAWRENCEVILLE, GA
NPI
1053054262
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
106S00000X Behavior Technician
Enumeration Date
2022-04-15
Last Update Date
2022-04-15
Business Address
TAMICIA DESTINY ELLISON
833 HURRICANE SHOALS RD NE
LAWRENCEVILLE, GA 30043-4821
Phone number: 833-628-8476
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Mailing Address
TAMICIA DESTINY ELLISON
2802 HIDDEN FOREST CT SE
ATLANTA, GA 30316-4216
Phone number:
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