Individual
KATHRYN ELLSWORTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A., CCC-SLP
Contact information
Practice address
4135 WEYMOUTH DR SE, GRAND RAPIDS, MI 49508-3763
(616) 443-1699
Mailing address
4135 WEYMOUTH DR SE, GRAND RAPIDS, MI 49508-3763
(616) 443-1699
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
7101004307
MI
Other
Enumeration date
09/01/2015
Last updated
09/01/2015
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