MICHAEL MARIO ELLIS

STOCKTON, CA
NPI1609311315
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date2017-01-04
Last Update Date2017-01-04
Business Address
-- MICHAEL MARIO ELLIS
1222 MONACO CT #28
STOCKTON, CA 95207-6742
Phone number: 209-644-6328
Mailing Address
-- MICHAEL MARIO ELLIS
1222 MONACO CT #28
STOCKTON, CA 95207-6742
Phone number: 209-644-6328
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