| Doctor Name: | MS. DEANNA RENAE ELLIS-CHOPIN |
| NPI Number: | 1013090679 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PSYCHOLOGIST |
| License Number: | 63301010775 |
| Business Practice Address: | 1686 Colfax Ave Benton Harbor, MI - 490227355 |
| Business Phone Number: | 2699268535 |
| Business Fax Number: | 2699268528 |
| Mailing Address: | 777 E Napier Ave Apt K6, BENTON HARBOR |
| State: | MI |
| Postal Code: | 490226136 |
| Phone Number: | 2693691753 |
| Fax Number: | 2699268528 |
| NPI Enumeration Date: | 10/24/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC1900X |
| License Number: | 63301010775 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Counseling |
| Taxonomy Definition: | |