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General NPI Number Information
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NPI Number | 1437486180
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Entity Type | Organization
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Legal Business Name | NATIONAL EDUCATIONAL TRAINING SYSTEMS
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Dates
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Enumeration Date | 11/17/2009
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Last Update Date | 11/17/2009
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Provider Practice Location Address
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Address Line | 376 AUTUMN TRL
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City | RINGGOLD
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State | GA
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Zip | 30736-4191
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Country | US
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Telephone | 727-365-8522
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Fax | 866-799-3496
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Provider Business Mailing Address
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Address Line | 376 AUTUMN TRL
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City | RINGGOLD
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State | GA
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Zip | 30736-4191
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Country | US
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Telephone | 727-365-8522
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Fax | 866-799-3496
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. LESLIE ELAINE ELLLIS
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Credential | PH.D.
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Telephone | 727-365-8522
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number | PSY3273
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PSY3273
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License Number State | GA
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