Individual provider · NPI-1

Alex Ds Ellis, MFT

Marriage & Family Therapist · Bishop, CA

NPI number1477055390
StatusActive
Last updated in NPPESJul 15, 2019

Details

NPI
1477055390
Entity type
Individual (NPI-1)
Name
Ms. Alex Ds Ellis
Credential
MFT
Sex
Female
Sole proprietor
Yes
Enumeration date
Mar 7, 2018
Last updated
Jul 15, 2019

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
106H00000X Marriage & Family Therapist27998CAYes

Other names

  • Debrasue Alexandria Ellis (Former Name)

Practice location

129 East Line St
Bishop, CA 93514

Phone 760-937-0711 · Fax 760-872-4191

Mailing address

Po Box 1554
Bishop, CA 93515

Phone 760-937-0711 · Fax 760-872-4191

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