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1164940508
LACEY MICHELLE ELLSWORTH
SAN DIEGO, CA
NPI
1164940508
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
235Z00000X Speech-Language Pathologist,
(Licence: CA 24933)
Enumeration Date
2017-09-06
Last Update Date
2017-09-06
Business Address
LACEY MICHELLE ELLSWORTH M.S., CCC-SLP
9620 CHESAPEAKE DR STE 103
SAN DIEGO, CA 92123-1324
Phone number: 559-707-0821
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Mailing Address
LACEY MICHELLE ELLSWORTH M.S., CCC-SLP
321 10TH AVE UNIT 1302
SAN DIEGO, CA 92101-7484
Phone number:
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