Individual
MRS. ALEESA JORDAN ELLISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
501 YATES ST, MOUNT VERNON, TX 75457-3233
(903) 537-4424
Mailing address
501 YATES ST, MOUNT VERNON, TX 75457-3233
(903) 537-4424
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
213101
TX
Other
Enumeration date
08/21/2018
Last updated
08/21/2018
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