Individual
MS. JOAN J ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
88 HAMMOND ST, SUITE 202, BANGOR, ME 04401-4953
(207) 461-0707
Mailing address
PO BOX 71, HUDSON, ME 04449-0071
(207) 327-2183
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP169
ME
Other
Enumeration date
05/07/2007
Last updated
07/09/2007
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