Individual
GISELLE ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CIT
Contact information
Practice address
1016 1/2 W 21ST AVE, COVINGTON, LA 70433-7443
(985) 335-4240
Mailing address
200 S GRANT ST, COVINGTON, LA 70433-1076
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
5617
LA
Other
Enumeration date
05/02/2023
Last updated
05/02/2023
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