Organization
AMANDA ELLIS,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA ELLIS LICSW (OWNER)
(651) 217-8600
Entity
Organization
Contact information
Practice address
2960 SNELLING AVE N STE 210, ROSEVILLE, MN 55113-2458
(651) 217-8600
Mailing address
2960 SNELLING AVE N STE 210, ROSEVILLE, MN 55113-2458
(651) 217-8600
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LICSW
MN
Other
Enumeration date
06/18/2017
Last updated
07/21/2022
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