Individual
STEPHANIE NICOLE ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1101 MUSEUM RD STE 7, CONWAY, AR 72032-8580
(501) 358-6535
Mailing address
75 OAK TREE CIR, CONWAY, AR 72032-2112
(406) 868-9184
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
01/02/2020
Last updated
01/02/2020
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