Individual
MARY ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
7 DRYDOCK AVE STE 2070, BOSTON, MA 02210-2303
(857) 203-6461
Mailing address
3640 COLONEL GLENN HWY, DAYTON, OH 45435-0001
(937) 775-3458
(937) 775-3434
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
11988
MA
Other
Enumeration date
12/22/2017
Last updated
06/21/2023
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