Individual
MECHELLE RENEE ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
12055 W 2ND PL, LAKEWOOD, CO 80228-1506
(303) 432-5354
Mailing address
4851 INDEPENDENCE ST, SUITE 200, WHEAT RIDGE, CO 80033-6715
(303) 425-0300
(303) 432-5071
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
NLC0012537
CO
Other
Enumeration date
04/03/2015
Last updated
04/03/2015
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