Individual
ANTHONY ELLIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC, NBCC, MA
Contact information
Practice address
2209 EASTERN AVE, PLYMOUTH, WI 53073-4281
(920) 892-7606
(920) 449-4247
Mailing address
2209 EASTERN AVE, PLYMOUTH, WI 53073-4281
(920) 892-7606
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
10475-125
WI
Other
Enumeration date
01/25/2022
Last updated
06/15/2023
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