Individual
PATRICIA TAYLOR ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
3676 N HARBOR LN STE 100, BOISE, ID 83703-6919
(208) 607-3503
Mailing address
675 E ANTON ST, MERIDIAN, ID 83646-6298
(208) 637-5102
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LMSW-44545
ID
Other
Enumeration date
01/10/2024
Last updated
01/10/2024
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