Individual
MR. JAMES LUTHER ELLISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS
Contact information
Practice address
33 BEACON HILL RD, COLUMBIA, SC 29210-5601
(803) 799-9025
(803) 931-8962
Mailing address
33 BEACON HILL RD, COLUMBIA, SC 29210-5601
(803) 799-9025
(803) 931-8962
Taxonomy
Speciality
Code
Description
License number
State
103TM1800X
Intellectual & Developmental Disabilities Psychologist
Primary
WP9945
SC
Other
Enumeration date
10/11/2006
Last updated
07/08/2007
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