Individual
FRANK ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
111 POND RD, LEWISTON, ME 04240-1604
(207) 784-0697
Mailing address
111 POND RD, LEWISTON, ME 04240-1604
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PS525
ME
Other
Enumeration date
08/26/2010
Last updated
08/26/2010
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