Individual
JAN ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
3738 HARRISON AVE, BUTTE, MT 59701-6823
(406) 497-7894
(406) 497-7918
Mailing address
90 TIGER ST, SAINT REGIS, MT 59866-9757
(406) 649-2311
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
9760
MT
Other
Enumeration date
12/16/2014
Last updated
12/16/2014
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