Temple Ellis | |
3050 Penton St Reynoldsburg OH 43068-8217 | |
(614) 354-0831 | |
Not Available |
Full Name | Temple Ellis |
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Speciality | Community/behavioral Health |
Location | 3050 Penton St, Reynoldsburg, Ohio |
Authorized Official Name and Position | Temple T Ellis (LICENSED INDEPENDENT SOCIAL WORKER) |
Authorized Official Contact | 6143540831 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Temple Ellis 3050 Penton St Reynoldsburg OH 43068-8217 Ph: (614) 354-0831 | Temple Ellis 3050 Penton St Reynoldsburg OH 43068-8217 Ph: (614) 354-0831 |
NPI Number | 1396125043 |
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Provider Enumeration Date | 06/08/2015 |
Last Update Date | 08/11/2015 |
Identifier | Type | State | Issuer |
---|---|---|---|
1396125043 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | I.1100139-SUPV (Ohio) | Primary |
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