Individual
LIBERTY ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LLPC
Contact information
Practice address
3150 PACKARD RD, YPSILANTI, MI 48197-1994
(734) 203-0183
Mailing address
121 PERRIN ST APT 2, YPSILANTI, MI 48197-2641
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6401018389
MI
Other
Enumeration date
06/29/2020
Last updated
06/29/2020
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