Lucretia Anastasia Ellick
Behavior Technician in Riverdale, GA. Individual provider (NPI-1).
NPI number1407613706
StatusActive
Last updated in NPPESMar 4, 2024
Details
- NPI
- 1407613706
- Entity type
- Individual (NPI-1)
- Name
- Lucretia Anastasia Ellick
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Mar 4, 2024
- Certification date
- Mar 3, 2024
- Last updated
- Mar 4, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106S00000X | Behavior Technician | – | GA | Yes |
Practice location
1441 Welton CtRiverdale, GA 30296-3039
Phone 404-484-2557
Mailing address
1441 Welton CtRiverdale, GA 30296-3039
Phone 404-484-2557
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All 38 Behavior Technician providers in Riverdale · All 1,059 providers in Riverdale
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