Individual
MARIAH ASHLEY ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LADC, LSW
Contact information
Practice address
530 W FIR AVE, FERGUS FALLS, MN 56537-1364
(218) 998-8166
(218) 998-8150
Mailing address
568 WESTVIEW AVE, FERGUS FALLS, MN 56537-1354
(218) 205-6483
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
305466
MN
Other
Enumeration date
07/22/2019
Last updated
07/08/2024
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