Individual
DEBORAH S ELLSWORTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, OTR/L
Contact information
Practice address
3 PINTO LN, LANDER, WY 82520-9756
(307) 714-4086
(307) 335-6539
Mailing address
3 PINTO LN, LANDER, WY 82520-9756
(307) 714-4086
(307) 335-6539
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
99
WY
Other
Enumeration date
06/29/2012
Last updated
06/29/2012
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