Individual
MRS. MICHELLE MARIE ELY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2630 CENTRAL AVE, EIELSON AFB, AK 99702-2301
(907) 377-4041
Mailing address
2630 CENTRAL AVE, EIELSON AFB, AK 99702-2301
(907) 377-4041
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
165433
AK
1041C0700X
Clinical Social Worker
LCSW86978
CA
Other
Enumeration date
02/10/2017
Last updated
06/13/2024
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