Provider First Line Business Practice Location Address:
ELLIE MENTAL HEALTH
Provider Second Line Business Practice Location Address:
10301 DEMOCRACY LANE, SUITE 302
Provider Business Practice Location Address City Name:
FAIRFAX
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
22030
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
571-223-7588
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/08/2024