Leslie Elaine Ellis, PHD

NPI #1730346792 in Lutz, Florida

Provider Information

NPI Number: 1730346792
Entity Type: Individual
Name: Leslie Elaine Ellis, PHD
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Psychologist - Clinical
Credential: PHD
Enumeration Date: May 19, 2008
Last Updated: May 19, 2008

Practice Location

Address: 207 CRYSTAL GROVE BLVD
City: Lutz
State: Florida
ZIP Code: 33548-6452
Phone: (813) 964-9101

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Psychologist - Clinical — Clinical	103TC0700X	Primary

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