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General NPI Number Information
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NPI Number | 1124546098
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Entity Type | Individual
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Provider Name | ADRIENNE ELLERS BCBA
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Gender | Female
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Dates
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Enumeration Date | 08/31/2017
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Last Update Date | 11/08/2024
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Provider Practice Location Address
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Address Line | 11808 N OHIO ST
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City | DUNNELLON
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State | FL
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Zip | 34431-6724
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Country | US
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Telephone | 352-342-5006
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Fax |
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Provider Business Mailing Address
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Address Line | 4981 N BAYWOOD DR
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City | BEVERLY HILLS
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State | FL
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Zip | 34465-4504
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Country | US
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Telephone | 352-342-5006
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Fax | 352-245-0766
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-08-4602
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License Number State | FL
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