Individual
MRS. MELINDA R ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S.W. L.C.S.W.
Contact information
Practice address
1722 SOUTH GLENSTONE, SUITE H, SPRINGFIELD, MO 65804-1513
(417) 881-9518
(417) 887-2051
Mailing address
1722 SOUTH GLENSTONE, SUITE H, SPRINGFIELD, MO 65804-1513
(417) 881-9518
(417) 887-2051
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2004030680
MO
Other
Enumeration date
06/05/2007
Last updated
07/08/2007
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