Ellis, Michelle Andree
Ellis, Michelle Andree is an sole proprietor health care provider with primary practice located at 639 E Speedway , Tucson AZ 85705. She recently has 4 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Psychologist, Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Clinical Child & Adolescent, Behavioral Health & Social Service Providers / School. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Ellis, Michelle Andree can be contacted via phone (520) 425-3456.Contact Information
Primary practice address
639 E Speedway
Tucson AZ 85705
Phone: (520) 425-3456
Fax: (520) 319-9712
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Behavioral Health & Social Service Providers / Psychologist | 103T00000X | 1319 | Arizona |
Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 1319 | Arizona |
Behavioral Health & Social Service Providers / Clinical Child & Adolescent | 103TC2200X | 1319 | Arizona |
Behavioral Health & Social Service Providers / School | 103TS0200X | 1319 | Arizona |
Behavioral Health & Social Service Providers / Clinical | 103TC0700X | AZ1319 | Arizona |
Profile Details
NPI number | 1750482253 |
---|---|
LBN Legal business name | Ellis, Michelle Andree |
Credentials | PHD |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Sep 26th, 2006 |
Last updated | Oct 27th, 2014 - about 11 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1750482253 | NPPES |
Arizona | MEDICAID | 428799 |
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