Individual
BRENDA ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
52 TOWNSHIP ROAD 1124, PROCTORVILLE, OH 45669-8524
(304) 412-0990
Mailing address
52 TOWNSHIP ROAD 1124, PROCTORVILLE, OH 45669-8524
(304) 412-0990
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Enumeration date
11/08/2022
Last updated
11/08/2022
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