Tina Marie Ellis, EARLY INTERVENTION
NPI #1083451918 in Mineral Wells, West Virginia
Provider Information
- NPI Number
- 1083451918
- Entity Type
- Individual
- Name
- Tina Marie Ellis, EARLY INTERVENTION
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Early Intervention Provider Agency
- Credential
- EARLY INTERVENTION
- Enumeration Date
- Jul 9, 2024
- Last Updated
- Jul 9, 2024
Practice Location
- Address
- 225 PLANTATION DR
- City
- Mineral Wells
- State
- West Virginia
- ZIP Code
- 26150-9638
- Phone
- (304) 483-3077
Specialties & Taxonomy Codes
| Specialty |
|---|
| Early Intervention Provider Agency |
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