Individual
BRIAN TODD ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMSW
Contact information
Practice address
1501 42ND ST, WEST DES MOINES, IA 50266-1005
(515) 333-9734
Mailing address
PO BOX 35944, DES MOINES, IA 50315-0326
(515) 333-9734
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
087137
IA
Other
Enumeration date
11/24/2017
Last updated
11/24/2017
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