Individual
CRYSTAL DAWN ELLISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
15755 PARKWAY LN APT 1, SOUTHGATE, MI 48195-4739
(313) 432-8885
Mailing address
15755 PARKWAY LN APT 1, SOUTHGATE, MI 48195-4739
(313) 432-8885
Taxonomy
Speciality
Code
Description
License number
State
171400000X
Health & Wellness Coach
—
MI
251S00000X
Community/Behavioral Health Agency
Primary
—
MI
405300000X
Prevention Professional
1346928405
MI
Other
Enumeration date
01/15/2026
Last updated
04/06/2026
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