Ellis, Mary Lucena

Ellis, Mary Lucena is an sole proprietor health care provider with primary practice located at 2810 45Th St , Rock Island IL 61201-5860. 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, Mary Lucena can be contacted via phone (309) 737-6304.

Contact Information

Primary practice address
2810 45Th St Rock Island IL 61201-5860
Phone: (309) 737-6304
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Speech, Language and Hearing Service Providers / Speech-Language Pathologist 235Z00000X 01132 Iowa
Speech, Language and Hearing Service Providers / Speech-Language Pathologist 235Z00000X MA7678 California
Speech, Language and Hearing Service Providers / Speech-Language Pathologist 235Z00000X Illinois

Profile Details

NPI number 1821297300
LBN Legal business name Ellis, Mary Lucena
Credentials MA-CCC/SLP
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 13th, 2007
Last updated Jul 13th, 2007 - about 19 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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