Individual
MR. CHARLES CARLISLE ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA, CCC-SLP
Contact information
Practice address
14015 SANTA FE CT, BAKERSFIELD, CA 93314-8357
(661) 747-3236
(661) 588-4242
Mailing address
PO BOX 20192, BAKERSFIELD, CA 93390-0192
(661) 747-3236
(661) 588-4242
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP4590
CA
Other
Enumeration date
08/22/2009
Last updated
08/22/2009
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