| NPI | 1366105207 |
|---|---|
| Former Name | AUDREN JANELLE ELLIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AR P2211007) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: AR p2211007) |
| Enumeration Date | 2021-10-18 |
| Last Update Date | 2024-01-31 |