| NPI | 1982683934 |
|---|---|
| Former Name | CYNTHIA M ELLIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 364SP0808X Clinical Nurse Specialist, Psych/Mental Health (Licence: NY 002173) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 002173) |
| Enumeration Date | 2006-01-10 |
| Last Update Date | 2020-01-10 |