Individual
MS. CHARMINE ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
B.S. CACM
Contact information
Practice address
16647 WYOMING, DETROIT, MI 48221
(313) 342-3606
(313) 861-0413
Mailing address
16647 WYOMING, DETROIT, MI 48221
(313) 342-3606
(313) 861-0413
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
MI
Other
Enumeration date
11/10/2009
Last updated
11/10/2009
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