Individual
DR. SUSAN G ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
3233 E BAY DR, SUITE 100, LARGO, FL 33771-1900
(727) 536-2200
(727) 531-5088
Mailing address
3233 E BAY DR, SUITE 100, LARGO, FL 33771-1900
(727) 536-2200
(727) 531-5088
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PY2173
FL
Other
Enumeration date
11/08/2006
Last updated
07/08/2007
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