| Temple Ellis | |
|
3050 Penton St Reynoldsburg OH 43068-8217 | |
| (614) 354-0831 | |
| Not Available |
| Full Name | Temple Ellis |
|---|---|
| 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 |
|---|---|
| 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 |
|---|---|
| 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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