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1700587995
NOLAN B ELLIS
SAN RAFAEL, CA
NPI
1700587995
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: CA 138041)
Enumeration Date
2023-03-14
Last Update Date
2023-03-14
Business Address
NOLAN B ELLIS
1974 LAS GALLINAS AVE
SAN RAFAEL, CA 94903-1740
Phone number: 415-302-2344
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Mailing Address
NOLAN B ELLIS
1974 LAS GALLINAS AVE
SAN RAFAEL, CA 94903-1740
Phone number: 415-302-2344
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