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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 12 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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Identifiers

StateTypeNumberIssuer
All States NPI 1750482253 NPPES
Arizona MEDICAID 428799

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