Individual
MS. MARYLYNN ELLSWORTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC, CTSS
Contact information
Practice address
2633 E INDIAN SCHOOL RD STE 250, PHOENIX, AZ 85016-0703
(602) 492-1010
Mailing address
4017 E TETHER TRL, PHOENIX, AZ 85050-8970
(480) 231-3184
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC-21654
AZ
Other
Enumeration date
06/15/2023
Last updated
06/15/2023
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