Individual
MRS. LINDA ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
2034 SAMANTHA DR, KANNAPOLIS, NC 28083-4103
(704) 960-9563
Mailing address
2034 SAMANTHA DR, KANNAPOLIS, NC 28083-4103
(704) 960-9563
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
1745
NC
Other
Enumeration date
02/04/2010
Last updated
02/04/2010
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