Individual
MS. SANDRA PEPPERCORN ELLISON
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
M.A., L.L.P
Contact information
Practice address
28511 ORCHARD LAKE RD, SUITE A, FARMINGTON HILLS, MI 48334-2933
(248) 489-1550
(248) 489-9767
Mailing address
28511 ORCHARD LAKE RD, SUITE A, FARMINGTON HILLS, MI 48334-2933
(248) 489-1550
(248) 489-9767
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6801065312
MI
Other
Enumeration date
06/15/2006
Last updated
07/08/2007
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