Individual
AMY ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
370 GOSHEN LN, GAHANNA, OH 43230-2713
(614) 478-5580
Mailing address
9095 WINSTON RD, PICKERINGTON, OH 43147-8177
(614) 519-5885
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OT-005688
OH
Other
Enumeration date
02/08/2017
Last updated
02/08/2017
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