Individual
LAKEN ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
146 TIMBER CREEK DR STE 101, CORDOVA, TN 38018-4396
(901) 654-5693
Mailing address
3971 KNIGHT ARNOLD RD, MEMPHIS, TN 38118-3004
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
6659
TN
Other
Enumeration date
02/26/2021
Last updated
11/15/2022
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