| 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 |