Individual
ELLIE MARTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8803 FARMSTEAD AVE, MONTICELLO, MN 55362-8836
(612) 281-8303
Mailing address
8803 FARMSTEAD AVE, MONTICELLO, MN 55362-8836
(612) 281-8303
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
22336
MN
Other
Enumeration date
05/26/2022
Last updated
05/26/2022
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