Individual
JASON LEE ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OTRL
Contact information
Practice address
719 ELYSIAN FIELDS AVE FL 2, NEW ORLEANS, LA 70117-8511
(504) 620-2209
Mailing address
719 ELYSIAN FIELDS AVE FL 2, NEW ORLEANS, LA 70117-8511
(504) 620-2209
(504) 620-2846
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
306766
LA
Other
Enumeration date
11/09/2017
Last updated
11/09/2017
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