Individual
MIKE H ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1950 WILLIAM ST, UNION, NJ 07083-4504
(908) 546-8947
Mailing address
1950 WILLIAM ST, UNION, NJ 07083-4504
(908) 546-8947
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
37LC00225500
NJ
Other
Enumeration date
05/18/2020
Last updated
05/18/2020
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