Desirae Serene Ellison

NPI #1093420028 in Beckley, West Virginia

Provider Information

NPI Number: 1093420028
Entity Type: Individual
Name: Desirae Serene Ellison
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Massage Therapist
Enumeration Date: Jan 13, 2023
Last Updated: Jan 13, 2023

Practice Location

Address: 21 MALLARD CT
City: Beckley
State: West Virginia
ZIP Code: 25801-3615
Phone: (304) 890-8020

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Massage Therapist	225700000X	Primary

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