Individual
ANGELA LYNN ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1548 W CAYUSE CREEK DR STE 100, MERIDIAN, ID 83646-4795
(208) 600-2072
Mailing address
770 W TANZANITE DR, KUNA, ID 83634-5635
(208) 912-4626
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
09/01/2025
Last updated
09/01/2025
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