Individual
ANNA HELENA ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S. LPC, LBP
Contact information
Practice address
1310 NW 20TH ST, OKLAHOMA CITY, OK 73106-4006
(405) 820-2763
(405) 604-0634
Mailing address
1310 NW 20TH ST, OKLAHOMA CITY, OK 73106-4006
(405) 820-2763
(405) 604-0634
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
0129
OK
101YP2500X
Professional Counselor
Primary
2825
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0129
LBP
OK
01
—
2825
LPC
OK
Enumeration date
09/01/2006
Last updated
07/08/2007
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