Individual
JENNIFER SHERMAINE ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
273 S 118TH EAST AVE, TULSA, OK 74128-2224
(918) 949-5588
Mailing address
273 S 118TH EAST AVE, TULSA, OK 74128-2224
(918) 949-5588
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
04/16/2013
Last updated
04/16/2013
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