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DR. JULIE ANN ELLIS PH.D.

>> Psychologist >> Behavioral Health & Social Service Providers

Registrant NPI Number: 1104144179

Individual Registrant:
DR. JULIE ANN ELLIS PH.D.
Gender: F
Sole Proprietor

Location and contact information for practice:
421 SW 128TH TER  NEWBERRY, FL 32669-3247 US
Tel: 352-281-2718  Fax: --

Contact information for business:
421 SW 128TH TER  NEWBERRY, FL 32669-3247 US
Tel: 352-281-2718  Fax: --

Registration Information:
NPI: 1104144179
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y103T00000XBehavioral Health & Social Service Providers
Psychologist
FLPY 8036

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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