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1619550084
ATHENA MARIE ELLENBURG
VALDOSTA, GA
NPI
1619550084
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
(Licence: GA RBT-20-148801)
Enumeration Date
2021-05-03
Last Update Date
2021-05-03
Business Address
ATHENA MARIE ELLENBURG
3121 N OAK STREET EXT
VALDOSTA, GA 31602-1099
Phone number: 800-832-9419
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Mailing Address
ATHENA MARIE ELLENBURG
3121 N OAK STREET EXT
VALDOSTA, GA 31602-1099
Phone number: 800-832-9419
Copy
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