Individual
JESSICA ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MHS, CCC-SLP
Contact information
Practice address
3545 S NATIONAL AVE, SPRINGFIELD, MO 65807-7310
(417) 269-5500
(417) 269-5508
Mailing address
PO BOX 802843, KANSAS CITY, MO 64180-2843
(417) 730-6430
(417) 269-7567
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2016011750
MO
Other
Enumeration date
08/01/2016
Last updated
04/20/2022
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