MR. Joshua Kyle Ellis, LPC

NPI #1811376429 in Vidalia, Georgia

Provider Information

NPI Number: 1811376429
Entity Type: Individual
Name: MR. Joshua Kyle Ellis, LPC
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Counselor - Professional
Credential: LPC
Enumeration Date: May 28, 2015
Last Updated: May 28, 2015

Practice Location

Address: 500 JACKSON ST
City: Vidalia
State: Georgia
ZIP Code: 30474-4730
Phone: (912) 253-8003

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Professional — Professional	101YP2500X	Primary

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