| NPI | 1174074637 |
|---|---|
| Former Name | STEPHANIE ELLIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2016-10-19 |
| Last Update Date | 2022-05-11 |