NPI | 1215296132 |
---|---|
Former Name | MELISSA JANE ELLIS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101Y00000X Counselor |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
Enumeration Date | 2012-05-12 |
Last Update Date | 2024-05-08 |