Individual
MRS. COLLEEN VIOLET ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
195 W 12TH AVE, EUGENE, OR 97401
(541) 762-4334
(541) 684-4156
Mailing address
687 CHESHIRE AVE, EUGENE, OR 97402-5060
(416) 844-1005
(541) 684-4156
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
04/07/2010
Last updated
04/11/2019
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