Ellis, Mattalue
Ellis, Mattalue is an individual health care provider with primary practice located at 11960 Westline Industrial Dr , Saint Louis MO 63146-3209. She recently has only one registered license in Behavioral Health & Social Service Providers / School, which is considered as her primary health care specialty. Ellis, Mattalue can be contacted via phone (314) 439-1949.Contact Information
Primary practice address
11960 Westline Industrial Dr
Saint Louis MO 63146-3209
Phone: (314) 439-1949
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / School | 101YS0200X | ||
| Behavioral Health & Social Service Providers / School | 103TS0200X |
Profile Details
| NPI number | 1851814644 |
|---|---|
| LBN Legal business name | Ellis, Mattalue |
| Credentials | Master of Arts (MA) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 24th, 2017 |
| Last updated | Jul 24th, 2017 - about 7 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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