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Individual

DR. ELLIE T STURGIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PHD

Contact information

Practice address
200 PROFESSIONAL PARK DR SE, SUITE 1, BLACKSBURG, VA 24060-6679
(540) 552-1402
(540) 552-3428
Mailing address
200 PROFESSIONAL PARK DR SE, SUITE 1, BLACKSBURG, VA 24060-6679
(540) 552-1402
(540) 552-3428

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0810001999
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
11511730
CAQH CREDENTIALING ID
Enumeration date
08/31/2006
Last updated
07/08/2007
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