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1104563733
DEKETRIA ELLIS
ANCHORAGE, AK
NPI
1104563733
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2022-05-16
Last Update Date
2022-05-16
Business Address
DEKETRIA ELLIS
1905 E 4TH AVE
ANCHORAGE, AK 99501-2908
Phone number: 907-279-2511
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Mailing Address
DEKETRIA ELLIS
1905 E 4TH AVE
ANCHORAGE, AK 99501-2908
Phone number: 907-279-2511
Copy
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