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Individual

MISS ELICIA NICOLE WELLS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
5211 MAHONING AVE STE 370, AUSTINTOWN, OH 44515-1853
(330) 792-4724
Mailing address
452 S RACCOON RD APT B21, AUSTINTOWN, OH 44515-3650
(804) 912-3626

Taxonomy

Speciality
Code
Description
License number
State
1041S0200X
School Social Worker
Primary
S.2202329-TRNE
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
340685251
OH
Enumeration date
01/31/2022
Last updated
01/31/2022
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