Individual
MRS. MICHELLE ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTL/R
Contact information
Practice address
185 CHATEAU DR SW STE 102, HUNTSVILLE, AL 35801-7415
(256) 489-1583
(256) 489-1595
Mailing address
185 CHATEAU DR SW STE 102, HUNTSVILLE, AL 35801-7415
(256) 489-1583
(256) 489-1595
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
5258
AL
225XM0800X
Mental Health Occupational Therapist
Primary
5258
AL
Other
Enumeration date
02/23/2021
Last updated
02/23/2021
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