Individual
ERIKA HILLARY ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
201 S MARKET ST, OTTUMWA, IA 52501-2924
(641) 683-5773
(641) 226-5759
Mailing address
PO BOX 458, OTTUMWA, IA 52501-0458
(641) 683-5773
(641) 226-5759
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
072640
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1912952367
—
IA
Enumeration date
05/13/2019
Last updated
05/13/2019
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