Lucretia Anastasia Ellick

NPI #1407613706 in Riverdale, Georgia

Provider Information

NPI Number: 1407613706
Entity Type: Individual
Name: Lucretia Anastasia Ellick
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Behavior Technician
Enumeration Date: Mar 4, 2024
Last Updated: Mar 4, 2024

Practice Location

Address: 1441 WELTON CT
City: Riverdale
State: Georgia
ZIP Code: 30296-3039
Phone: (404) 484-2557

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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