Individual
GARRETT BRANDON ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCPC/C
Contact information
Practice address
67 EUSTIS PKWY, WATERVILLE, ME 04901-5173
(207) 873-2136
Mailing address
67 EUSTIS PKWY, WATERVILLE, ME 04901-5173
(207) 873-2136
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
XL4725
ME
Other
Enumeration date
07/08/2016
Last updated
07/08/2016
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