Individual
EVELYN ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LMFT
Contact information
Practice address
5200 PARK RD, SUITE 219, CHARLOTTE, NC 28209-3650
(704) 995-3380
Mailing address
5200 PARK RD, SUITE 219, CHARLOTTE, NC 28209-3650
(704) 995-3380
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
1205
NC
Other
Enumeration date
07/02/2013
Last updated
11/13/2013
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