Individual
MRS. ELLYN M ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., B.C.B.A.
Contact information
Practice address
33 TURNPIKE RD, SOUTHBOROUGH, MA 01772-2108
(508) 481-1015
(508) 485-3421
Mailing address
33 TURNPIKE RD, SOUTHBOROUGH, MA 01772-2108
(508) 481-1015
(508) 485-3421
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-02-0957
MA
Other
Enumeration date
11/17/2010
Last updated
11/17/2010
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