Individual
CAROLINA CORONEL ELLISTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
9606 MESA DR, HOUSTON, TX 77078-3024
(832) 548-5000
Mailing address
PO BOX 66308, HOUSTON, TX 77266-6308
(832) 548-5000
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
61168
TX
Other
Enumeration date
03/24/2020
Last updated
01/28/2021
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