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1851831754
MARY MAE ELLISON
OAKLAND, CA
NPI
1851831754
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101Y00000X Counselor
Additional Taxonomies
225400000X Rehabilitation Practitioner
Enumeration Date
2017-02-27
Last Update Date
2022-10-30
Business Address
MARY MAE ELLISON
3301 E 12TH ST STE 259
OAKLAND, CA 94601-2940
Phone number: 510-269-9030
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Mailing Address
MARY MAE ELLISON
1454 HUMPHREY DR APT D
SUISUN CITY, CA 94585-1933
Phone number:
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