Individual
MS. ELLEN ANN GALLUP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4389 ORANGEDALE RD, CHAGRIN FALLS, OH 44022-1438
(216) 470-2769
Mailing address
4389 ORANGEDALE RD, CHAGRIN FALLS, OH 44022-1438
(216) 470-2769
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0383335
—
OH
01
—
1831516
OHIO DODD CONTRACT NUMBER
OH
Enumeration date
04/01/2021
Last updated
04/01/2021
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