Individual
MR. EZEKIEL ELISIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
11 ROBINSON ST, POTTSTOWN, PA 19464-6421
(484) 941-0500
Mailing address
1358 MARK DR, WEST CHESTER, PA 19380-6214
(610) 639-2038
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
04/30/2014
Last updated
04/30/2014
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