Individual
EMILY ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1155 LISBON ST, LEWISTON, ME 04240-5025
(207) 783-4663
Mailing address
1155 LISBON ST, LEWISTON, ME 04240-5025
(207) 783-4663
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
XL 3957
ME
Other
Enumeration date
08/28/2012
Last updated
08/28/2012
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