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1528107158
MARINA J. ELLIS
POCATELLO, ID
NPI
1528107158
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YP2500X Counselor Professional
(Licence: ID LCPC303)
Enumeration Date
2007-02-06
Last Update Date
2007-07-09
Business Address
MARINA J. ELLIS LCPC
427 N ARTHUR AVE STE B
POCATELLO, ID 83204-3006
Phone number: 208-637-0334
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Mailing Address
MARINA J. ELLIS LCPC
PO BOX 5474
CHUBBUCK, ID 83202-0003
Phone number: 208-637-0334
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