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Individual

MRS. KRISTIN JENNIFER ELLIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OTR/L

Contact information

Practice address
850 E BUTLER RD, GREENVILLE, SC 29607-5842
(864) 527-9453
Mailing address
530 CLARENDON DR, EASLEY, SC 29642-9334
(864) 607-8696

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2905

Other

Enumeration date
04/22/2013
Last updated
04/22/2013
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