Individual
ANNA ELLISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
530 NE GLEN OAK AVE, PEORIA, IL 61637-0001
(309) 655-3779
Mailing address
530 NE GLEN OAK AVE, PEORIA, IL 61637-0001
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Enumeration date
07/16/2021
Last updated
07/16/2021
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