Individual provider · Type 1 NPI

Dominique Ellison

Mental Health Counselor · Shreveport, LA

NPI number 1144754482 Active

Practice location

301 Dalzell St
Shreveport, LA 71104-2431

Call (318) 200-9156 Map

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

Mental Health Counselor: Definition to come...

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About NPI 1144754482

Dominique Ellison's National Provider Identifier is 1144754482, issued on Apr 13, 2017. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Shreveport, LA. The record was last updated on Apr 13, 2017.