Individual
DR. AMY E. ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
1650 NE 26TH ST STE 201, WILTON MANORS, FL 33305-1431
(516) 459-3137
Mailing address
1650 NE 26TH ST STE 201, WILTON MANORS, FL 33305-1431
(516) 459-3137
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PY9396
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PY9396
FLORIDA PSYCHOLOGIST
FL
Enumeration date
01/15/2016
Last updated
02/01/2021
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