MICHAEL ETHEN ELLISON

SANTA ROSA, CA
NPI1316657349
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YM0800X Counselor, Mental Health
Enumeration Date2022-11-30
Last Update Date2022-11-30
Business Address
MICHAEL ETHEN ELLISON
2300 NORTHPOINT PKWY
SANTA ROSA, CA 95407-5004
Phone number: 707-571-8452
Mailing Address
MICHAEL ETHEN ELLISON
2300 NORTHPOINT PKWY
SANTA ROSA, CA 95407-5004
Phone number: 707-571-8452
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