Individual
COREY ELLOW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
908 W JUDGE PEREZ DR, SUITE C, CHALMETTE, LA 70043-4773
(504) 324-5298
Mailing address
908 W JUDGE PEREZ DR, SUITE C, CHALMETTE, LA 70043-4773
(504) 324-5298
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
LA
101Y00000X
Counselor
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1750754727
MHR
LA
05
—
1750754727
—
LA
Enumeration date
04/25/2016
Last updated
04/25/2016
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