Individual
ELLIE BANNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7075 W BELL RD STE 1, GLENDALE, AZ 85308-8547
(602) 669-3506
Mailing address
7075 W BELL RD STE 1, GLENDALE, AZ 85308-8547
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
16137
AZ
Other
Enumeration date
06/26/2024
Last updated
03/17/2025
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