Ellis, Jacqueline A
Ellis, Jacqueline A is an sole proprietor health care provider with primary practice located at 204 Austin Ave , Columbia MO 65203-4078. She recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as her primary health care specialty. Ellis, Jacqueline A can be contacted via phone (573) 875-1718.Contact Information
Primary practice address
204 Austin Ave
Columbia MO 65203-4078
Phone: (573) 875-1718
Fax: (573) 875-1431
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Psychologist | 103T00000X | PY00548 | Missouri |
Profile Details
| NPI number | 1992821730 |
|---|---|
| LBN Legal business name | Ellis, Jacqueline A |
| Credentials | PHD |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 22nd, 2007 |
| Last updated | Jul 9th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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