Individual
HOLLY ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
107 CARPENTER DR STE 210, STERLING, VA 20164-4468
(703) 297-4368
Mailing address
711 BERRY ST, FALLS CHURCH, VA 22042-2401
(571) 730-7808
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0810004210
VA
Other
Enumeration date
08/31/2019
Last updated
08/31/2019
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