Individual
MR. COREY JASON ELLISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPCA
Contact information
Practice address
145 SCALEYBARK RD, CHARLOTTE, NC 28209-2687
(704) 608-3886
(704) 536-6030
Mailing address
145 SCALEYBARK RD, CHARLOTTE, NC 28209-2687
(704) 608-3886
(704) 536-6030
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
A9913
NC
Other
Enumeration date
01/14/2013
Last updated
01/14/2013
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