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Individual

PHILIP ELLISON-HINES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LMFTA

Contact information

Practice address
200 S PENDLETON AVE STE 212, PENDLETON, IN 46064-1189
(317) 813-9064
Mailing address
11650 OLIO RD STE 1000-191, FISHERS, IN 46037-7619

Taxonomy

Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
85000536A
IN

Other

Enumeration date
12/05/2023
Last updated
12/05/2023
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