Jay Harold Ellens PHD CSW

NPI 1699047290 - Psychologist - 103TC1900X

NPI Details
NPI 1699047290
Gender Male
Enumeration Date 01/30/2012
Last Updated 01/30/2012
Entity Type Individual
Active Over 4 years ago
Practice Location
26705 FARMINGTON RD
FARMINGTON HILLS MI, 48334-4329, US
Phone (248) 231-4433
Fax
Business Location
26705 FARMINGTON RD
FARMINGTON HILLS MI, 48334-4329, US
Phone (248) 231-4433
Fax
Toxanomy
Taxonomy Code 103TC1900X
License State Michigan
License Number 4087 (NBCC-NCC)
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According to our database, Dr. Jay Harold Ellens PHD CSW NPI is 1699047290, taxonomy code is 103TC1900X and license number is 4087 (NBCC-NCC), license state is located at Michigan. Jay Harold Ellens PHD CSW physically located at 26705 Farmington Rd, Farmington Hills MI, 48334-4329. NPI Number Jay Harold Ellens PHD CSW has the Individual type.

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1699047290 NPI number is provided on an as is basis without warranty of any kind. 1699047290 is maintained by the National Plan & Provider Enumeration System. The contents of Jay Harold Ellens PHD CSW are for informational purposes only.