NPI 1023827516

Charlie Laverne Ellis

Practitioner Occupational Therapy Assistant Leesburg, GA

Practice location

Address: 119 Jefferson CT, Leesburg, GA 31763-4920
Phone: (229) 869-3919

Registered specialties

Occupational Therapy Assistant Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 224Z00000X Licence OTA001662 (GA)

Other Occupational Therapy Assistant providers in Georgia →

Registry record

NPI: 1023827516
Entity type: Individual
Sex (as registered): Female
NPI issued: 30 Dec 2024
Record last updated: 30 Dec 2024

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.