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1407613706
LUCRETIA ANASTASIA ELLICK
RIVERDALE, GA
NPI
1407613706
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
Enumeration Date
2024-03-04
Last Update Date
2024-03-04
Business Address
LUCRETIA ANASTASIA ELLICK
1441 WELTON CT
RIVERDALE, GA 30296-3039
Phone number: 404-484-2557
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Mailing Address
LUCRETIA ANASTASIA ELLICK
1441 WELTON CT
RIVERDALE, GA 30296-3039
Phone number: 404-484-2557
Copy
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