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1356658108
CHRISTIAN DANYELL ELLIS FREDERICK
SAN DIEGO, CA
NPI
1356658108
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: IN 34005465A)
Enumeration Date
2010-08-31
Last Update Date
2010-08-31
Business Address
-- CHRISTIAN DANYELL ELLIS FREDERICK LCSW, CCM
4715 VIEWRIDGE AVE STE 110
SAN DIEGO, CA 92123-1680
Phone number: 800-257-8715
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Mailing Address
-- CHRISTIAN DANYELL ELLIS FREDERICK LCSW, CCM
8105 GRASSY MEADOW CT
INDIANAPOLIS, IN 46259-7728
Phone number: 317-965-3349
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