Larry D. Ellis

NPI #1124499405 in Corinth, Mississippi

Provider Information

NPI Number: 1124499405
Entity Type: Individual
Name: Larry D. Ellis
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Counselor - Mental Health
Enumeration Date: Oct 13, 2015
Last Updated: Oct 13, 2015

Practice Location

Address: 2664 S HARPER RD
City: Corinth
State: Mississippi
ZIP Code: 38834-6723
Phone: (662) 287-4055

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Mental Health — Mental Health	101YM0800X	Primary

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