Individual
EARL EDWARD ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.ED., LPA
Contact information
Practice address
890 RINEYVILLE RD, ELIZABETHTOWN, KY 42701-8927
(270) 234-9236
(270) 234-8367
Mailing address
890 RINEYVILLE RD, ELIZABETHTOWN, KY 42701-8927
(270) 234-9236
(270) 234-8367
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
0952
KY
Other
Enumeration date
06/11/2007
Last updated
08/29/2013
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