Individual
MACY ELLETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1813 WILLOW ST STE 4D, VINCENNES, IN 47591-4279
(812) 887-7056
Mailing address
1080 W COUNTY ROAD 850 S, CARLISLE, IN 47838-8377
(812) 887-7056
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
22008315A
IN
Other
Enumeration date
12/05/2022
Last updated
12/05/2022
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