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Individual

EUSTACIA ELLISON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTR/L

Contact information

Practice address
33-57 HARRISON ST, PICCIANO 3, JOHNSON CITY, NY 13790-2107
(607) 763-5200
Mailing address
33-57 HARRISON ST, PICCIANO 3, JOHNSON CITY, NY 13790-2107
(607) 763-5200

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
225XR0403X
Driving and Community Mobility Occupational Therapist

Other

Enumeration date
12/29/2008
Last updated
12/29/2008
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