Individual
BERNADINE ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
115 S WOOSTER AVE, DOVER, OH 44622-1944
(833) 510-4357
(866) 460-2997
Mailing address
615 ELSINORE PL, CINCINNATI, OH 45202-1459
(833) 510-4357
(866) 460-2997
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
150171
OH
Other
Enumeration date
08/10/2018
Last updated
08/29/2022
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