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1114487188
JESSICA MARIE ELLIS
COVINGTON, KY
NPI
1114487188
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: KY 164249)
Enumeration Date
2019-03-25
Last Update Date
2019-03-25
Business Address
JESSICA MARIE ELLIS LCDCIII, CADC
1450 MADISON AVE
COVINGTON, KY 41011-3369
Phone number: 859-444-4499
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Mailing Address
JESSICA MARIE ELLIS LCDCIII, CADC
419 AVON CT
CRESCENT PARK, KY 41017-1616
Phone number: 859-250-8460
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