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Individual

JILL ELLINGSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MA, LMFT

Contact information

Practice address
445 BROADWAY AVE STE A, ST PAUL PARK, MN 55071
(612) 242-1224
(651) 340-2587
Mailing address
445 BROADWAY AVE STE A, ST PAUL PARK, MN 55071-1554
(612) 242-1224
(651) 340-2587

Taxonomy

Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
2671
MN
106H00000X
Marriage & Family Therapist

Other

Enumeration date
11/15/2012
Last updated
02/10/2020
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