Ellis, Ayana Damell

Ellis, Ayana Damell is an individual health care provider with primary practice located at 100 N Main St , Suffolk VA 23434-4529. 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, Ayana Damell can be contacted via phone (757) 925-6764.

Contact Information

Primary practice address
100 N Main St Suffolk VA 23434-4529
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Speech, Language and Hearing Service Providers / Speech-Language Pathologist 235Z00000X 2202009572 Virginia

Profile Details

NPI number 1730743790
LBN Legal business name Ellis, Ayana Damell
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 25th, 2019
Last updated Aug 23rd, 2023 - about 3 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1730743790 NPPES
Virginia MEDICAID 2204000200

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