Individual
CHANELLE ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
44421 10TH ST W, LANCASTER, CA 93534-3335
(818) 654-3912
(818) 241-6853
Mailing address
44421 10TH ST W, LANCASTER, CA 93534-3335
(818) 654-3912
(818) 241-6853
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
12/16/2018
Last updated
02/13/2023
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