Grant Martin Ellison

NPI #1710360573 in Wayne, Michigan

Provider Information

NPI Number
1710360573
Entity Type
Individual
Name
Grant Martin Ellison
Gender
Not Specified
Sole Proprietor
Yes
Primary Specialty
Psychologist - Clinical
Enumeration Date
Jun 29, 2015
Last Updated
Jun 29, 2015

Practice Location

Address
35640 W MICHIGAN AVE
City
Wayne
ZIP Code
48184-1628
Phone
(734) 729-7792

Specialties & Taxonomy Codes

Specialty
Psychologist - ClinicalClinical

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