Ellis, Mavonna Marie

Ellis, Mavonna Marie is an individual health care provider with primary practice located at 1616 S August St , Stillwater OK 74074-1837. She recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as her primary health care specialty. Ellis, Mavonna Marie can be contacted via phone (405) 564-0656.

Contact Information

Primary practice address
1616 S August St Stillwater OK 74074-1837
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 3974 Oklahoma

Profile Details

NPI number 1124064233
LBN Legal business name Ellis, Mavonna Marie
Credentials PHD
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 20th, 2006
Last updated Oct 15th, 2008 - about 18 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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