Individual
YVETTE K ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MAED-BHT
Contact information
Practice address
4423 W ELLIS STREET, LAVEEN, AZ 85339
(480) 200-9266
Mailing address
PO BOX 67102, PHOENIX, AZ 85082-7102
(480) 200-9266
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
11/10/2020
Last updated
11/10/2020
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