Individual
ANNA ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LADC, LPCC
Contact information
Practice address
1875 STATION PKWY NW, ANDOVER, MN 55304-3319
(763) 482-9598
Mailing address
18205 45TH AVE N STE D, PLYMOUTH, MN 55446-4594
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
305435
MN
101YM0800X
Mental Health Counselor
Primary
3115
MN
Other
Enumeration date
12/13/2021
Last updated
01/31/2024
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