Individual
AILEEN HITOMI ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
715 E ELK AVE UNIT C, GLENDALE, CA 91205-1750
(818) 220-1664
Mailing address
715 E ELK AVE UNIT C, GLENDALE, CA 91205-1750
(818) 220-1664
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA4
CA
Other
Enumeration date
10/14/2011
Last updated
10/14/2011
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