Individual
ELLIS MOTLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMSW
Contact information
Practice address
6610 SE QUAKERVALE RD, RIVERTON, KS 66770-4185
(620) 848-2300
(620) 848-2301
Mailing address
PO BOX 550, RIVERTON, KS 66770-0550
(620) 848-2300
(620) 848-2301
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
3043
KS
Other
Enumeration date
03/13/2007
Last updated
07/08/2007
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