Mistie Rose Ellsworth

NPI #1932799517 in Peoria, Arizona

Provider Information

NPI Number: 1932799517
Entity Type: Individual
Name: Mistie Rose Ellsworth
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Behavior Technician
Enumeration Date: Jan 19, 2021
Last Updated: Jan 19, 2021

Practice Location

Address: 20470 N LAKE PLEASANT RD STE 107
City: Peoria
State: Arizona
ZIP Code: 85382-9708
Phone: (623) 248-3324

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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