GRANT MARTIN ELLISON

WAYNE, MI
NPI1710360573
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy103TC0700X Psychologist, Clinical
(Licence: MI  6301016324)
Enumeration Date2015-06-29
Last Update Date2015-06-29
Business Address
-- GRANT MARTIN ELLISON
35640 W MICHIGAN AVE
WAYNE, MI 48184-1628
Phone number: 734-729-7792
Mailing Address
-- GRANT MARTIN ELLISON
4763 GATEWOOD CIR APT 3B
YPSILANTI, MI 48197-5035
Phone number: