Individual
MS. MAUREEN ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW, LCSW
Contact information
Practice address
4151 THOMAS AVE N, MINNEAPOLIS, MN 55412
(818) 209-9885
Mailing address
4151 THOMAS AVE N, MINNEAPOLIS, MN 55412-1517
(612) 310-8683
(651) 925-0441
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
26144
CA
Other
Enumeration date
11/16/2012
Last updated
06/08/2018
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