Individual
DR. MELISSA ELLSWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
881 W BAXTER DR STE 100, SOUTH JORDAN, UT 84095-8506
(801) 382-8702
Mailing address
3349 S COPPER BEND RD, MAGNA, UT 84044-3614
(240) 478-8892
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
11172768-2501
UT
Other
Enumeration date
03/26/2020
Last updated
10/06/2020
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