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1477183754
JAMES BRADLEY ELLIS
FORT PAYNE, AL
NPI
1477183754
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: AL 4301C)
Enumeration Date
2020-01-25
Last Update Date
2020-01-26
Business Address
JAMES BRADLEY ELLIS LICSW
1306 67TH ST NW
FORT PAYNE, AL 35967-8306
Phone number: 334-425-4295
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Mailing Address
JAMES BRADLEY ELLIS LICSW
1306 67TH ST NW
FORT PAYNE, AL 35967-8306
Phone number: 334-425-4295
Copy
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