Individual
MS. JODIE LYNN ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
5000 W NATIONAL AVE, MILWAUKEE, WI 53295-0001
(414) 384-2000
(414) 389-4199
Mailing address
2414 MAIN AVE, SHEBOYGAN, WI 53083-3854
(920) 980-6947
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
WI
Other
Enumeration date
05/17/2007
Last updated
07/08/2007
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