NPI 1194198697
Amanda Ellis
Practice location
- Address
- 381 East Brook Street, San Tan Valley, AZ 85140
- Phone
- (480) 495-2839
- Mailing address
- 381 E Brook St, San Tan Valley, AZ 85140
Registered specialties
Physical Disabilities Residential Treatment Facility
Primary
Registry record
- NPI
- 1194198697
- Entity type
- Individual
- Sex (as registered)
- Female
- NPI issued
- 5 Nov 2015
- Record last updated
- 5 Nov 2015
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.