| NPI | 1972218055 |
|---|---|
| Doing Business As | ELLIE MENTAL HEALTH - ST. PETERSBURG |
| Entity Type | Organization |
| Authorized Contact | KATHERINE PLANCHARD Clinic Director 508-212-6095 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X |
| Enumeration Date | 2023-01-23 |
| Last Update Date | 2023-09-14 |