| NPI | 1467731836 |
|---|---|
| Other Name | THERESA GREENLEE ELLIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IN 99048259A) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: IN 99048259A) |
| 103T00000X Psychologist (Licence: IN 99048259A) | |
| 103TA0700X Psychologist, Adult Development & Aging (Licence: IN 99048259A) | |
| 103TH0004X Psychologist, Health (Licence: IN 99048259A) | |
| 103TR0400X Psychologist, Rehabilitation (Licence: IN 99048259A) | |
| Enumeration Date | 2011-08-16 |
| Last Update Date | 2016-11-29 |