Individual
TIERRA ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
14900 SWEITZER LN STE 200, LAUREL, MD 20707-2915
(240) 360-2161
(240) 360-1938
Mailing address
14900 SWEITZER LN STE 200, LAUREL, MD 20707-2915
(240) 360-2161
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
230313968
MD
Other
Enumeration date
06/05/2023
Last updated
06/05/2023
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