Nicquelette Ellison
Psychologist, Clinical in Tyler, TX. Individual provider (NPI-1).
NPI number1912745472
StatusActive
Last updated in NPPESOct 19, 2026
Details
- NPI
- 1912745472
- Entity type
- Individual (NPI-1)
- Name
- Nicquelette Ellison
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jul 18, 2024
- Certification date
- Oct 19, 2026
- Last updated
- Oct 19, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103TC0700X | Psychologist, Clinical | 40960 | TX | Yes |
Practice location
2830 W Grande Blvd Apt 3102Tyler, TX 75703-3392
Phone 813-919-5860
Mailing address
2830 W Grande Blvd Apt 3102Tyler, TX 75703-3392
Phone 813-919-5860
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