Individual
KIJUANA ELLAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1500 THE XING, ROCK HILL, SC 29732-7207
(803) 379-4118
Mailing address
1500 THE XING, ROCK HILL, SC 29732-7207
(803) 379-4118
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
8470
SD
101YP2500X
Professional Counselor
8470
SC
101YS0200X
School Counselor
—
—
Other
Enumeration date
02/02/2024
Last updated
02/02/2024
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