Individual
ELISSA LOCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
114 GREENWOOD PL, BENTON, KY 42025-7640
(270) 703-7398
Mailing address
3648 US HIGHWAY 68 E, BENTON, KY 42025-8048
(270) 703-0567
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
KY
Other
Enumeration date
05/29/2016
Last updated
05/29/2016
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