Individual
DR. TASHA J ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
7801 E BUSH LAKE RD STE 130, MINNEAPOLIS, MN 55439-3152
(763) 244-4900
Mailing address
2985 CENTRE POINTE DR # 230, ROSEVILLE, MN 55113-1105
(310) 390-6612
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP6620
MN
103TC0700X
Clinical Psychologist
LP6620
MN
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
CA
Other
Enumeration date
08/16/2011
Last updated
04/28/2026
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