Individual
FALLON ELLINGTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., QBHP
Contact information
Practice address
4953 SCHAEFER RD, DEARBORN, MI 48126-3260
(248) 558-9850
Mailing address
645 E FOX HILLS DR, BLOOMFIELD HILLS, MI 48304-1305
(248) 835-2623
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
11/17/2015
Last updated
08/16/2023
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