Individual
MISS PATRICE ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
506 WELLINGTON RD, JACKSON, MS 39206-5443
(769) 237-0191
Mailing address
506 WELLINGTON RD, JACKSON, MS 39206-5443
(769) 237-0191
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
33686
MD
Other
Enumeration date
08/20/2025
Last updated
08/20/2025
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