Provider Demographics
NPI:1720727712
Name:FRANCE-ELLIS, BRIANNE ANGEL (PSYD)
Entity type:Individual
Prefix:DR
First Name:BRIANNE
Middle Name:ANGEL
Last Name:FRANCE-ELLIS
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3132 THUNDERBIRD CT E
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60503-5583
Mailing Address - Country:US
Mailing Address - Phone:313-318-0406
Mailing Address - Fax:
Practice Address - Street 1:5864 INTERFACE DR STE D
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48103-9514
Practice Address - Country:US
Practice Address - Phone:734-994-9466
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-31
Last Update Date:2022-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6351004475103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty