Anne Ellingson, PROVISIONAL

NPI #1841665668 in Jackson, Wyoming

Provider Information

NPI Number
1841665668
Entity Type
Individual
Name
Anne Ellingson, PROVISIONAL
Gender
Not Specified
Sole Proprietor
No
Primary Specialty
Counselor - Addiction (Substance Use Disorder)
Credential
PROVISIONAL
Enumeration Date
Dec 4, 2015
Last Updated
Dec 4, 2015

Practice Location

Address
610 W BROADWAY AVE
Address 2
SUITE L1
State
Wyoming
ZIP Code
83001-8213
Phone
(307) 733-3908

Specialties & Taxonomy Codes

Specialty
Counselor - Addiction (Substance Use Disorder)Addiction (Substance Use Disorder)

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