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Individual

ELLIE DOUGLASS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1400 EASTSIDE RD, PLATTEVILLE, WI 53818-9800
(608) 348-2331
Mailing address
1400 EASTSIDE RD, PLATTEVILLE, WI 53818-9800
(608) 348-2331

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
8840-26
WI
225X00000X
Occupational Therapist

Other

Enumeration date
02/07/2024
Last updated
04/01/2025
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