Individual
MRS. MARTHA BRUNER ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ED.S., LPC, NCC
Contact information
Practice address
698 SILVER HILLS DR, PRATTVILLE, AL 36066-6184
(334) 358-2455
(334) 358-4909
Mailing address
698 SILVER HILLS DR, PRATTVILLE, AL 36066-6184
(334) 358-2455
(334) 358-4909
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
1835
AL
Other
Enumeration date
10/16/2006
Last updated
07/08/2007
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