Individual
MS. ALEX DS ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MFT
Contact information
Practice address
129 EAST LINE ST, BISHOP, CA 93514
(760) 937-0711
(760) 872-4191
Mailing address
PO BOX 1554, BISHOP, CA 93515
(760) 937-0711
(760) 872-4191
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
27998
CA
Other
Enumeration date
03/07/2018
Last updated
07/15/2019
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