Individual
KEANA MARIE ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8427 DORSEY CIR STE 101, MANASSAS, VA 20110-4596
(855) 750-5861
Mailing address
8427 DORSEY CIR STE 101, MANASSAS, VA 20110-4596
(703) 637-7700
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
164W00000X
Licensed Practical Nurse
0002106749
VA
Other
Enumeration date
07/29/2025
Last updated
08/04/2025
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