Provider Demographics
NPI:1194189621
Name:ELLEN MORRISON
Entity Type:Organization
Organization Name:ELLEN MORRISON
Other - Org Name:E.L.M. WELLNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIETITIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELLEN
Authorized Official - Middle Name:LACHOWICZ
Authorized Official - Last Name:MORRISON
Authorized Official - Suffix:
Authorized Official - Credentials:MS, RDN, LDN, CEDRD
Authorized Official - Phone:919-656-3448
Mailing Address - Street 1:4917 WATERS EDGE DR
Mailing Address - Street 2:220-7
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27606-2459
Mailing Address - Country:US
Mailing Address - Phone:919-656-3448
Mailing Address - Fax:919-714-0488
Practice Address - Street 1:4917 WATERS EDGE DR
Practice Address - Street 2:220-7
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27606-2459
Practice Address - Country:US
Practice Address - Phone:919-656-3448
Practice Address - Fax:919-714-0488
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-11
Last Update Date:2016-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL001534133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty