Individual
DR. LAUREN M. ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
10 GRACE AVE, OFFICE #6, GREAT NECK, NY 11021-2447
(646) 535-2641
Mailing address
10 GRACE AVE, OFFICE #6, GREAT NECK, NY 11021-2447
(646) 535-2641
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
019389-1
NY
Other
Enumeration date
12/07/2010
Last updated
09/19/2012
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