Doctor Name: | RONALD FRED ELLIS |
NPI Number: | 1225019078 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | LC1320 |
Business Practice Address: | 49 Old Solomons Island Rd Ste 303 Annapolis, MD - 21401 |
Business Phone Number: | 4105731944 |
Business Fax Number: | 4105731972 |
Mailing Address: | 1509 Ritchie Hwy, Ste F ARNOLD |
State: | MD |
Postal Code: | 21012 |
Phone Number: | 4107572077 |
Fax Number: | 4107575184 |
NPI Enumeration Date: | 11/09/2005 |
NPI Last Update Date: | 07/18/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | LC1320 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MD |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |