Individual
MRS. JACQUELYN L ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
3122 ANCHORMAN WAY, NORTH LAS VEGAS, NV 89031-0558
(702) 651-0911
Mailing address
3122 ANCHORMAN WAY, NORTH LAS VEGAS, NV 89031-0558
(702) 651-0911
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2440-C
NV
Other
Enumeration date
10/28/2009
Last updated
12/11/2018
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