Individual
DESTINY ELLISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9715 LABETTE DR, LITTLE ROCK, AR 72205-6703
(501) 413-2167
Mailing address
2628 GREEN VALLEY DR, TOLEDO, OH 43614-4983
(501) 413-2167
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
AR
385H00000X
Respite Care
Primary
—
AR
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
AR
Other
Enumeration date
10/02/2025
Last updated
10/02/2025
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