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1811376429
JOSHUA KYLE ELLIS
VIDALIA, GA
NPI
1811376429
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YP2500X Counselor Professional
(Licence: GA LPC008312)
Enumeration Date
2015-05-28
Last Update Date
2015-05-28
Business Address
MR. JOSHUA KYLE ELLIS LPC
500 JACKSON ST
VIDALIA, GA 30474-4730
Phone number: 912-253-8003
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Mailing Address
MR. JOSHUA KYLE ELLIS LPC
500 JACKSON ST
VIDALIA, GA 30474-4730
Phone number: 912-253-8003
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