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Individual

DR. DEANNA RENAE ELLIS-CHOPIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PSYCHOLOGIST

Contact information

Practice address
1800 PIPESTONE RD # 8776, BENTON HARBOR, MI 49022-2311
(269) 369-1753
Mailing address
PO BOX 8776, BENTON HARBOR, MI 49023-8776
(269) 369-1753

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
103TA0400X
Addiction (Substance Use Disorder) Psychologist
103TC1900X
Counseling Psychologist
Primary
6361000635
MI
103TM1800X
Intellectual & Developmental Disabilities Psychologist
6301010775
MI

Other

Enumeration date
10/24/2006
Last updated
08/11/2022
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