Marina J. Ellis, LCPC
Counselor, Professional in Pocatello, ID. Individual provider (NPI-1).
NPI number1528107158
StatusActive
Last updated in NPPESJul 9, 2007
Details
- NPI
- 1528107158
- Entity type
- Individual (NPI-1)
- Name
- Marina J. Ellis
- Credential
- LCPC
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Feb 6, 2007
- Last updated
- Jul 9, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YP2500X | Counselor, Professional | LCPC303 | ID | Yes |
Practice location
427 N Arthur Ave Ste BPocatello, ID 83204-3006
Phone 208-637-0334 · Fax 208-237-9670
Mailing address
Po Box 5474Chubbuck, ID 83202-0003
Phone 208-637-0334 · Fax 208-237-9670
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All 75 Professional Counselor providers in Pocatello · All 2,770 providers in Pocatello
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