Mattison Ellis's National Provider Identifier (NPI) Details
Mattison Ellis, LPC
NPI: 1851461917
Enumeration Date: 2006-11-08
Last updated: 2007-07-08
Sole Proprietor: YES
Status: active
Postal Address: 8829 CENTRE ST, SUITE 105, SOUTHAVEN, MS
Phone: 662-280-6777
Primary Practice Address: 8829 CENTRE ST, SUITE 105, SOUTHAVEN, MS
Practice's phone: 662-280-6777