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Organization
CENTER FOR EXCELLENCE
Active
Organization
CENTER FOR EXCELLENCE
Active
Other names
C. Rick Ellis, Ed.D.
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CARL RICHARD ELLIS ED.D. (SOLE PROPRIETOR)
(757) 640-1882
Entity
Organization
Contact information
Practice address
4101 GRANBY ST, SUITE 301, NORFOLK, VA 23504-1117
(757) 640-1882
(757) 640-0253
Mailing address
4101 GRANBY ST, SUITE 301, NORFOLK, VA 23504-1117
(757) 640-1882
(757) 640-0253
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
0810001913
VA
Other
Enumeration date
12/18/2007
Last updated
12/18/2007
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