Individual
MRS. JADE ELLENBROOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LLP
Contact information
Practice address
23810 MICHIGAN AVE, DEARBORN, MI 48124-1830
(313) 757-1391
(313) 359-4811
Mailing address
23810 MICHIGAN AVE, DEARBORN, MI 48124-1830
(313) 757-1391
(313) 359-4811
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6361006204
MI
Other
Enumeration date
08/21/2014
Last updated
09/25/2023
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