Individual
MICHELLE A ELLISOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
4601 SPICEWOOD SPRINGS RD, BUILDING 4, SUITE 200, AUSTIN, TX 78759-8598
(512) 467-1376
Mailing address
4806 PARK LN, AUSTIN, TX 78732-1733
(512) 294-5595
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
201652
TX
Other
Enumeration date
01/10/2011
Last updated
07/15/2013
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