Individual
ANDREA ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LGPC
Contact information
Practice address
1110 BENFIELD BLVD, MILLERSVILLE, MD 21108-2639
(410) 756-0035
Mailing address
13115 LARCHDALE RD APT 12, LAUREL, MD 20708-1753
(240) 595-0892
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LGP10366
MD
Other
Enumeration date
05/23/2020
Last updated
05/23/2020
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