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Individual

MS. NIAAH ELLIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
B.A.H.C.S.

Contact information

Practice address
4812 E. MCNICHOLS, DETROIT, MI 48212
(313) 368-4800
Mailing address
20226 SANTA ROSA DR, DETROIT, MI 48221-1291
(313) 221-3352

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary

Other

Enumeration date
10/20/2009
Last updated
10/20/2009
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