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1083301840
REBECCA WALLER-ELLISON
LAKELAND, FL
NPI
1083301840
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: FL IMH20732)
Enumeration Date
2023-04-21
Last Update Date
2023-04-21
Business Address
REBECCA WALLER-ELLISON MA
905 S MISSOURI AVE
LAKELAND, FL 33803-1033
Phone number: 863-450-3626
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Mailing Address
REBECCA WALLER-ELLISON MA
1119 SUGARTREE DR S
LAKELAND, FL 33813-1867
Phone number: 863-640-3220
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