Individual
DIAN T ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5536 KAREN ELAINE DR APT 1606, NEW CARROLLTON, MD 20784-4149
(202) 207-0760
Mailing address
5536 KAREN ELAINE DR APT 1606, NEW CARROLLTON, MD 20784-4149
(202) 207-0760
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
CNA20210460
MD
Other
Enumeration date
02/10/2021
Last updated
02/10/2021
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