Individual
CODY ELY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
219 W BROWN ST STE A, ENNIS, TX 75119-4738
(210) 251-9989
Mailing address
800 WILLIAMSBURG DR, ENNIS, TX 75119-8214
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
16494
TX
Other
Enumeration date
07/04/2025
Last updated
07/04/2025
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