Individual
MRS. JULIE ELLEDGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMFT182
Contact information
Practice address
610 W BROADWAY AVE, 109, JACKSON, WY 83001-8213
(307) 200-8777
Mailing address
220 W PEARL AVE, 3501, JACKSON, WY 83001-8406
(307) 200-8777
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
LMFT182
WY
106H00000X
Marriage & Family Therapist
MFC33952
CA
Other
Enumeration date
08/14/2014
Last updated
08/14/2014
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