IndividualActive
Grant Ellison
NPI 1710360573 · Clinical Psychologist · Wayne, MI
Grant Ellison is a Clinical Psychologist provider in Wayne, MI (NPI 1710360573).
Provider details
- NPI number
- 1710360573
- Entity type
- Individual
- Primary specialty
- Clinical PsychologistBehavioral Health & Social Service Providers
- Sex
- Male
- Sole proprietor
- Yes
- License
- 6301016324 (MI)
Practice location
35640 W Michigan Ave
Wayne, MI 48184-1628
Phone: (734) 729-7792
Street-level locationGet directions
Mailing address
4763 Gatewood Cir
Ypsilanti, MI 48197-5035
Registry dates
- Enumerated
- 2015-06-29
- Last updated
- 2015-06-29
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.