Provider Demographics
NPI:1427292283
Name:ELLING, ROSEANNE P (PHD)
Entity type:Individual
Prefix:
First Name:ROSEANNE
Middle Name:P
Last Name:ELLING
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2800 N DALLAS PKWY
Mailing Address - Street 2:SUITE 220
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-5993
Mailing Address - Country:US
Mailing Address - Phone:972-473-0500
Mailing Address - Fax:
Practice Address - Street 1:2800 N DALLAS PKWY
Practice Address - Street 2:SUITE 220
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-5993
Practice Address - Country:US
Practice Address - Phone:972-473-0500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-23
Last Update Date:2009-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11702101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional