Individual
COURTNEY ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5104 E VAN BUREN ST APT 2065, PHOENIX, AZ 85008-7022
(619) 873-7958
Mailing address
5104 E VAN BUREN ST, #2065, PHOENIX, AZ 85008-7013
(619) 873-7958
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
05/08/2014
Last updated
07/28/2014
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