Individual
STACIE J ELLISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS CCC-SLP
Contact information
Practice address
10609 W. WILLOWBROOK DR, SUN CITY, AZ 85373-6528
(623) 698-6311
Mailing address
10609 W. WILLOWBROOK DR, SUN CITY, AZ 85373-6528
(623) 698-6311
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP0355
AZ
Other
Enumeration date
05/16/2006
Last updated
02/15/2019
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