| NPI | 1033393798 |
|---|---|
| Doing Business As | C. RICK ELLIS, ED.D. |
| Entity Type | Organization |
| Authorized Contact | CARL RICHARD ELLIS Sole Proprietor 757-640-1882 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: VA 0810001913) |
| Enumeration Date | 2007-12-18 |
| Last Update Date | 2007-12-18 |