Organization
TEMPLE ELLIS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TEMPLE T ELLIS LISW-S (LICENSED INDEPENDENT SOCIAL WORKER)
(614) 354-0831
Entity
Organization
Contact information
Practice address
3050 PENTON ST, REYNOLDSBURG, OH 43068-8217
(614) 354-0831
Mailing address
3050 PENTON ST, REYNOLDSBURG, OH 43068-8217
(614) 354-0831
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
I.1100139-SUPV
OH
Other
Enumeration date
06/08/2015
Last updated
08/11/2015
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