Individual
KAREN ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
305 MAIN ST, HANNA, WY 82327
(307) 320-3082
Mailing address
PO BOX 195, HANNA, WY 82327-0195
(307) 320-3082
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6722561-3501
UT
1041C0700X
Clinical Social Worker
LCSW-1028
WY
Other
Enumeration date
11/12/2013
Last updated
03/17/2018
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