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Individual

ANDREA ELLIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PC

Contact information

Practice address
1875 N RIDGE RD E, LORAIN, OH 44055-3371
(440) 260-6108
(440) 240-0193
Mailing address
1875 N RIDGE RD E, LORAIN, OH 44055-3371
(440) 260-6108
(440) 240-0193

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
C.0700234.TEMP
OH

Other

Enumeration date
06/16/2009
Last updated
06/16/2009
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