Individual
CRISTAL ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAC
Contact information
Practice address
211 S MAIN ST, BENTON, AR 72015
(501) 672-2339
(501) 214-6867
Mailing address
211 S MAIN ST, BENTON, AR 72015
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
A2401026
AR
Other
Enumeration date
01/26/2018
Last updated
01/29/2024
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