Individual
DR. JAMES T ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D., BCBA
Contact information
Practice address
461 RIVER RD, ANDOVER, MA 01810-4213
(978) 654-4300
Mailing address
166 BOSTON ST # 3, DORCHESTER, MA 02125-1142
(978) 806-1906
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
1-05-2212
MA
103TC0700X
Clinical Psychologist
Primary
7985
MA
Other
Enumeration date
03/19/2011
Last updated
03/19/2011
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