| Amanda Ellis,llc | |
|
2960 Snelling Ave N Ste 210 Roseville MN 55113-2458 | |
| (651) 217-8600 | |
| Not Available |
| Full Name | Amanda Ellis,llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 2960 Snelling Ave N Ste 210, Roseville, Minnesota |
| Authorized Official Name and Position | Amanda Ellis (OWNER) |
| Authorized Official Contact | 6512178600 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Amanda Ellis,llc 2960 Snelling Ave N Ste 210 Roseville MN 55113-2458 Ph: (651) 217-8600 | Amanda Ellis,llc 2960 Snelling Ave N Ste 210 Roseville MN 55113-2458 Ph: (651) 217-8600 |
| NPI Number | 1699205146 |
|---|---|
| Provider Enumeration Date | 06/18/2017 |
| Last Update Date | 07/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699205146 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | LICSW (Minnesota) | Primary |
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