Individual
THERESA A ELLISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CSAC
Contact information
Practice address
13 BAY ST, CHIPPEWA FALLS, WI 54729-2437
(715) 726-9023
(715) 726-9055
Mailing address
17230 95TH AVE, CHIPPEWA FALLS, WI 54729-5189
(715) 896-3555
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
13165
WI
Other
Enumeration date
03/16/2010
Last updated
03/16/2010
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