Individual
AMY CAROL ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.M.H.C.
Contact information
Practice address
5200 WOODBINE RD, PACE, FL 32571-8715
(850) 261-9032
(850) 994-6958
Mailing address
5091 SAN MIGUEL ST, MILTON, FL 32583-5630
(850) 261-9032
(850) 994-6958
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
MH6475
FL
Other
Enumeration date
08/21/2006
Last updated
07/08/2007
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