Individual provider · Type 1 NPI

Mavonna Marie Ellis, PhD

Mental Health Counselor · Stillwater, OK

NPI number 1124064233 Active

Practice location

1616 S August St
Stillwater, OK 74074-1837

Call (405) 564-0656 Map

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800X3974 (OK)

Mental Health Counselor: Definition to come...

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About NPI 1124064233

Mavonna Marie Ellis, PhD's National Provider Identifier is 1124064233, issued on Jun 20, 2006. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Stillwater, OK. The record was last updated on Oct 15, 2008.