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1336589290
DESTI A. ELLIS
MODESTO, CA
NPI
1336589290
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
Enumeration Date
2013-06-25
Last Update Date
2018-01-26
Business Address
DESTI A. ELLIS LCSW, CAS
500 N 9TH ST STE C
MODESTO, CA 95350-5814
Phone number: 209-558-4420
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Mailing Address
DESTI A. ELLIS LCSW, CAS
800 SCENIC DR BLDG 4
MODESTO, CA 95350-6131
Phone number: 209-988-4058
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