| NPI | 1982258745 |
|---|---|
| Other Name | MELISSA ELLIS |
| Entity Type | Organization |
| Authorized Contact | MELISSA ELLIS Owner 225-803-1142 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2019-07-30 |
| Last Update Date | 2021-07-13 |