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NPI Profile for Dr KEIAH ELLIS in SHREVEPORT, LA.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Pastoral |
101YP1600X |
| NPI # | 1114428091 |
|
| Status | Active | |
| Credentials | PhD | |
| Entity | Individual | |
| Enumeration date | 02/26/2018 | |
| Last updated | 02/26/2018 - About 8 years ago | |
| Sole proprietor 1 | Yes | |
| Identifiers | Not Available | |
| Hospital affiliation(s) | Not Available |
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KEIAH ELLIS
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KEIAH ELLIS, PhD