Individual
ETHAN ELLINGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
C,D,C,A
Contact information
Practice address
519 COURT ST, PORTSMOUTH, OH 45662-3933
(740) 876-4370
Mailing address
519 COURT ST, PORTSMOUTH, OH 45662-3933
(740) 876-4370
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
177699
OH
Other
Enumeration date
07/26/2021
Last updated
07/26/2021
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