Ellis, Andrea Louise
Ellis, Andrea Louise is an sole proprietor health care provider with primary practice located at 102 Smithfield St , Buckhannon WV 26201-2620. She recently has only one registered license in Speech, Language and Hearing Service Providers / Speech-Language Pathologist, which is considered as her primary health care specialty. Ellis, Andrea Louise can be contacted via phone (304) 624-6554.Contact Information
Primary practice address
102 Smithfield St
Buckhannon WV 26201-2620
Phone: (304) 624-6554
Fax: (304) 624-5223
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Speech, Language and Hearing Service Providers / Speech-Language Pathologist | 235Z00000X | West Virginia |
Profile Details
| NPI number | 1639340151 |
|---|---|
| LBN Legal business name | Ellis, Andrea Louise |
| Credentials | MS,CCC/SLP |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 13th, 2008 |
| Last updated | Mar 13th, 2008 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1639340151 | NPPES |
| West Virginia | MEDICAID | 0140140000 |
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