Individual
AMANDA ELIZABETH ELLSWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
31557 SCHOOLCRAFT RD STE 200, LIVONIA, MI 48150-1848
(734) 466-5021
Mailing address
31557 SCHOOLCRAFT RD STE 200, LIVONIA, MI 48150-1848
(734) 466-5021
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
05/09/2018
Last updated
05/09/2018
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