Individual
JESSICA ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7530 GOODWIN RD, CHATTANOOGA, TN 37421-3182
(423) 567-4802
Mailing address
6209 VERONICA DR, OOLTEWAH, TN 37363-6453
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
1666
TN
Other
Enumeration date
02/22/2021
Last updated
02/22/2021
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