| Lori Ellis | |
|
2861 Executive Dr Clearwater FL 33762-2264 | |
| (727) 631-5959 | |
| Not Available |
| Full Name | Lori Ellis |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 2861 Executive Dr, Clearwater, Florida |
| Authorized Official Name and Position | Lori Ellis (OWNER) |
| Authorized Official Contact | 7276315959 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lori Ellis 2861 Executive Dr Clearwater FL 33762-2264 Ph: (727) 631-5959 | Lori Ellis 2861 Executive Dr Clearwater FL 33762-2264 Ph: (727) 631-5959 |
| NPI Number | 1184157687 |
|---|---|
| Provider Enumeration Date | 04/11/2017 |
| Last Update Date | 04/11/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184157687 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | SW7158 (Florida) | Primary |
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