NPI | 1225760309 |
---|---|
Doing Business As | ELLIE MENTAL HEALTH |
Entity Type | Organization |
Authorized Contact | PAMELA LATARSHA BUCHANAN Owner/President 636-866-2308 |
Organization Subpart ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical |
Enumeration Date | 2022-06-28 |
Last Update Date | 2022-06-28 |