Individual
ELLIE ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7110 JORDAN DR, RAPID CITY, SD 57702-8738
(605) 791-7400
Mailing address
7110 JORDAN DR, RAPID CITY, SD 57702-8738
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
728
SD
Other
Enumeration date
11/03/2017
Last updated
11/03/2017
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