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Individual

TARAH ELLIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1348 PALMETTO AVE, TOLEDO, OH 43606-4240
(419) 283-3387
Mailing address
1348 PALMETTO AVE, TOLEDO, OH 43606-4240
(419) 283-3387

Taxonomy

Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0097664
WAVIER
OH
Enumeration date
02/14/2017
Last updated
04/02/2022
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