Individual
MISS BAILEE ANN ELLENZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2500 N PALM CANYON DR STE A1-A4, PALM SPRINGS, CA 92262-1868
(760) 424-5602
Mailing address
2500 N PALM CANYON DR STE A1-A4, PALM SPRINGS, CA 92262-1868
(760) 424-5602
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
MPSS-AOFCZS
CA
Other
Enumeration date
04/03/2025
Last updated
06/17/2025
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