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Individual

SUE CAROL ELLIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
SLP

Contact information

Practice address
1941 VIRGINIA AVE, CONNERSVILLE, IN 47331-2879
(765) 827-7964
Mailing address
1941 VIRGINIA AVE, CONNERSVILLE, IN 47331-2879
(765) 827-7964
(859) 224-4675

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
139767
KY
235Z00000X
Speech-Language Pathologist
Primary
22008888A
IN
235Z00000X
Speech-Language Pathologist
KY-2447
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
12500849
KY
Enumeration date
07/16/2007
Last updated
10/06/2025
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