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1003369430
JEREMY ELLIS
BOULDER, CO
NPI
1003369430
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2016-08-02
Last Update Date
2016-08-02
Business Address
-- JEREMY ELLIS
1501 YARMOUTH AVE
BOULDER, CO 80304-0564
Phone number: 303-786-9314
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Mailing Address
-- JEREMY ELLIS
1501 YARMOUTH AVE
BOULDER, CO 80304-0564
Phone number: 303-786-9314
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