Individual
JEANETTE ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
245 HOMEWOOD PL, RESERVE, LA 70084-5527
(504) 559-0039
Mailing address
245 HOMEWOOD PL, SUITE E, RESERVE, LA 70084-5527
(504) 559-0039
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
02/10/2017
Last updated
02/10/2017
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