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Individual

MS. NATASHA ANTOINETTE ELLIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CPSS, CRC

Contact information

Practice address
40075 EATON ST, 202, CANTON, MI 48187-4500
(734) 981-1442
Mailing address
1465 TAMARIND AVE 685, 685, LOS ANGELES, CA 90028
(734) 772-8640

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MI

Other

Enumeration date
10/25/2011
Last updated
07/28/2021
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