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Organization

CENTER FOR EXCELLENCE

Active
Other names
C. Rick Ellis, Ed.D.
Organization subpart
No

Provider details

NPI number
Authorized official
MR. CARL RICHARD ELLIS ED.D. (SOLE PROPRIETOR)
(757) 640-1882
Entity
Organization

Contact information

Practice address
4101 GRANBY ST, SUITE 301, NORFOLK, VA 23504-1117
(757) 640-1882
(757) 640-0253
Mailing address
4101 GRANBY ST, SUITE 301, NORFOLK, VA 23504-1117
(757) 640-1882
(757) 640-0253

Taxonomy

Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
0810001913
VA

Other

Enumeration date
12/18/2007
Last updated
12/18/2007
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