Individual
CATHY ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
35425 W MICHIGAN AVE, WAYNE, MI 48184-9800
(734) 467-7600
Mailing address
13880 CAMBRIDGE ST APT 123, SOUTHGATE, MI 48195-1681
(734) 218-4292
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6801098342
MI
Other
Enumeration date
08/11/2015
Last updated
08/11/2015
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