| NPI | 1417653650 |
|---|---|
| Doing Business As | ELLIE MENTAL HEALTH |
| Entity Type | Organization |
| Authorized Contact | SAM TIERNEY Treasurer 319-855-3549 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2023-01-31 |
| Last Update Date | 2024-02-12 |