Individual
MRS. HEATHER ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
5707 N 22ND ST, TAMPA, FL 33610
(813) 673-4622
(813) 356-1691
Mailing address
5707 N 22ND ST, TAMPA, FL 33610
(813) 673-4622
(813) 356-1691
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
10/05/2006
Last updated
07/08/2007
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