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Individual

ELLEN KOSKI PONTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
L.M.F.T.

Contact information

Practice address
1305 S CANNON BLVD, KANNAPOLIS, NC 28083
(704) 939-1100
(704) 939-1173
Mailing address
1305 S CANNON BLVD, KANNAPOLIS, NC 28083-6232

Taxonomy

Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
553
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
6105160
NC
Enumeration date
10/03/2006
Last updated
11/28/2007
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