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1417656323
ELLEN SUPER THOMAS
MABLETON, GA
NPI
1417656323
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YP2500X Counselor Professional
(Licence: GA LPC011541)
Enumeration Date
2023-02-28
Last Update Date
2023-02-28
Business Address
ELLEN SUPER THOMAS LPC
783 CREEK GLEN RD
MABLETON, GA 30126-2797
Phone number: 404-840-8234
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Mailing Address
ELLEN SUPER THOMAS LPC
783 CREEK GLEN RD
MABLETON, GA 30126-2797
Phone number: 404-840-8234
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