Individual
MEGAN A ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
30 TECHNOLOGY DR, ROCKY MOUNT, VA 24151-3008
(540) 483-5044
(540) 483-0583
Mailing address
24 CLAY ST, MARTINSVILLE, VA 24112-2810
(276) 632-7128
(276) 632-0127
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0701004749
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004945221
—
VA
Enumeration date
01/19/2010
Last updated
01/19/2010
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