Individual
ROBERT DANIEL ELLIS JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA, LMFT
Contact information
Practice address
715 PINE ST, KANNAPOLIS, NC 28081-4215
(704) 224-8606
Mailing address
PO BOX 858, KANNAPOLIS, NC 28082-0858
(704) 224-8606
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
1539
NC
Other
Enumeration date
10/16/2013
Last updated
10/16/2013
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