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DR. JULIE ANN ELLIS PH.D.
>> Psychologist >> Behavioral Health & Social Service ProvidersRegistrant NPI Number: 1104144179
Individual Registrant:DR. JULIE ANN ELLIS PH.D.
Gender: F
Sole Proprietor
Gender: F
Sole Proprietor
Location and contact information for practice:
421 SW 128TH TER NEWBERRY, FL 32669-3247 US
Tel: 352-281-2718 Fax: --
Tel: 352-281-2718 Fax: --
Contact information for business:
421 SW 128TH TER NEWBERRY, FL 32669-3247 US
Tel: 352-281-2718 Fax: --
Tel: 352-281-2718 Fax: --
Registration Information:
NPI: 1104144179
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 103T00000X | Behavioral Health & Social Service Providers Psychologist | FL | PY 8036 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
