Individual
DARA ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
8400 N MOPAC EXPY, SUITE 302, AUSTIN, TX 78759-8328
(512) 537-6322
Mailing address
2809 W WILLIAM CANNON DR APT B203, AUSTIN, TX 78745-5145
(512) 537-6322
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
54210
TX
Other
Enumeration date
11/27/2012
Last updated
11/27/2012
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