Individual
GARRETT M ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
1119 W KENNEDY AVE, SUITE A, KIMBERLY, WI 54136-2213
(715) 349-7069
Mailing address
NORTHWEST COUNSELING & GUIDANCE CLINIC, PO BOX 309, SIREN, WI 54872-0309
(715) 349-7069
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
5141
WI
Other
Enumeration date
10/04/2022
Last updated
08/27/2024
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