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Individual

JESSICA ELLIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
COTA/L

Contact information

Practice address
1513 SALEM RD, SALEM TWP, ME 04983-4201
(207) 678-2701
Mailing address
144 VACATION ESTATES LN, FARMINGTON, ME 04938-5259

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OA4330
ME

Other

Enumeration date
08/29/2022
Last updated
08/29/2022
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