Individual
BETTY ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
91 BAY BRIDGE DR, GULF BREEZE, FL 32561-4468
(850) 291-0340
(850) 916-9547
Mailing address
91 BAY BRIDGE DR, GULF BREEZE, FL 32561-4468
(850) 291-0340
(850) 916-9547
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SW5647
FL
Other
Enumeration date
05/19/2006
Last updated
10/28/2011
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