Individual
SOPHIE ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ED.S.
Contact information
Practice address
9217 UNIVERSITY BLVD STE C1A, NORTH CHARLESTON, SC 29406-9147
(843) 619-7989
Mailing address
1206 RAVEN RD, HANAHAN, SC 29410-8509
(843) 813-3566
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
227408
SC
Other
Enumeration date
06/07/2018
Last updated
06/07/2018
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