Individual
SHANNON MARIE ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2814 AMHERST ST, INDIANAPOLIS, IN 46268-1266
(317) 914-3408
Mailing address
2814 AMHERST ST, INDIANAPOLIS, IN 46268-1266
(317) 914-3408
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
33009349A
IN
Other
Enumeration date
03/13/2023
Last updated
03/13/2023
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