| NPI | 1831945484 |
|---|---|
| Doing Business As | ELLIE MENTAL HEALTH - SPACE COAST |
| Entity Type | Organization |
| Authorized Contact | MICHAEL MOSLEY Vice President 321-525-1103 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 106H00000X Marriage & Family Therapist | |
| Enumeration Date | 2024-04-25 |
| Last Update Date | 2025-03-05 |