Individual
DESIRAE SERENE ELLISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
21 MALLARD CT, BECKLEY, WV 25801-3615
(304) 890-8020
(681) 207-7029
Mailing address
4714 OKEY L PATTESON RD, SCARBRO, WV 25917-8022
(304) 520-1426
(681) 207-7029
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
2018-3632
WV
Other
Enumeration date
01/13/2023
Last updated
01/13/2023
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