Individual
MICHAEL V ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
1A PINE WEST PLZ, ALBANY, NY 12205-5557
(518) 416-9500
(518) 862-1668
Mailing address
4 BERKSHIRE DR W, CLIFTON PARK, NY 12065-1741
(518) 862-1533
(518) 716-4880
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
008630
NY
Other
Enumeration date
07/11/2006
Last updated
04/27/2016
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