Individual
MRS. ANGELA ELLISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
220 BAGLEY ST, SUITE 700, DETROIT, MI 48226-1400
(313) 961-0346
(313) 961-0456
Mailing address
220 BAGLEY ST, SUITE 700, DETROIT, MI 48226-1400
(313) 961-0346
(313) 961-0456
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
6802071382
MI
Other
Enumeration date
08/23/2007
Last updated
08/23/2007
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