Organization
LAUREL RIDGE PSYCHOLOGICAL ASSOCIATES
Active
Other names
Laurel Ridge Psychological Associates
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID T ELLIS PSY.D. (PSYCHOLOGIST/PARTNER)
(304) 487-6121
Entity
Organization
Contact information
Practice address
211 HUNTER PARK, LAUREL RIDGE PSYCHOLOGICAL ASSOCIATES, PRINCETON, WV 24740
(304) 487-6121
(304) 487-8741
Mailing address
211 HUNTER PARK, LAUREL RIDGE PSYCHOLOGICAL ASSOCIATES, PRINCETON, WV 24740
(304) 487-6121
(304) 487-8741
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
988
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810006182
—
WV
05
—
3810016706
—
WV
Enumeration date
12/11/2006
Last updated
03/20/2017
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