Most Relevant Information
Provider Data
| NPI Number: | 1003644253 |
| Provider Name: | ARIEL MADISON ELLIS LEP, MA, PPS, NCSP |
| Entity Type: | Individual |
| Taxonomy Code: | 103TS0200X |
| Specialty: | Psychologist |
| License Number: | LEP4456 |
Most Important Dates
| Enumeration Date: | 07/22/2024 |
| Last Updated: | 07/22/2024 |
Provider Practice Location
3 EL CORTEZ CIR
CHICO
CA
959261210
Practice Location Phone/Fax
| Phone: | 5303328249 |
| Fax: |
Provider Mailing Location
550 VALLOMBROSA AVENUE PO BOX #201
CHICO
CA
95926
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |