Organization
JENNIFER ELLIS, M.ED, LPC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER MARIE ELLIS LPC (LICENSED PROFESSIONAL COUNSELOR)
(609) 413-6089
Entity
Organization
Contact information
Practice address
464 PARKER AVE, PHILADELPHIA, PA 19128-4402
(609) 413-6089
Mailing address
464 PARKER AVE, PHILADELPHIA, PA 19128-4402
(609) 413-6089
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
PC006176
PA
Other
Enumeration date
11/23/2014
Last updated
11/23/2014
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