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1982091690
DIANE CAROL ELLIS
GLENDALE, AZ
NPI
1982091690
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker Clinical
(Licence: AZ LCSW-2855)
Enumeration Date
2015-04-20
Last Update Date
2015-04-20
Business Address
DIANE CAROL ELLIS LCSW
5527 W MARCONI AVE
GLENDALE, AZ 85306-2402
Phone number: 602-329-7938
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Mailing Address
DIANE CAROL ELLIS LCSW
5527 W MARCONI AVE
GLENDALE, AZ 85306-2402
Phone number: 602-329-7938
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