Individual
HALEY ELLISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
401 N ALF COLEMAN RD, PANAMA CITY BEACH, FL 32407-2567
(850) 249-2004
Mailing address
7401 DIEHL CT, LOUISVILLE, KY 40220-2198
(502) 552-4472
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
22004
FL
Other
Enumeration date
01/13/2022
Last updated
01/13/2022
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