Raven Keturah Ellis, LCPC
NPI #1003909664 in Randallstown, Maryland
Provider Information
- NPI Number
- 1003909664
- Entity Type
- Individual
- Name
- Raven Keturah Ellis, LCPC
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Counselor - Professional
- Credential
- LCPC
- Enumeration Date
- Oct 2, 2006
- Last Updated
- Jul 8, 2007
Practice Location
- Address
- 3525 RESOURCE DRIVE ROOM C47
- City
- Randallstown
- State
- Maryland
- ZIP Code
- 21133
- Phone
- (410) 655-7655
Specialties & Taxonomy Codes
| Specialty |
|---|
| Counselor - Professional — Professional |
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