Individual
ELLORA TOLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
126 SEYMOUR AVE, JACKSON, MI 49202-3558
(734) 219-3314
Mailing address
313 WASHINGTON ST, LESLIE, MI 49251-9484
(517) 662-9481
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
6451022753
MI
101Y00000X
Counselor
—
—
Other
Enumeration date
01/13/2023
Last updated
03/15/2023
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