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1184220204
SALLY ELLSWORTH
BEND, OR
NPI
1184220204
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
175T00000X Peer Specialist
(Licence: OR 000004375)
Enumeration Date
2020-12-05
Last Update Date
2020-12-05
Business Address
SALLY ELLSWORTH
20813 LIBERTY LN
BEND, OR 97701-8596
Phone number: 541-279-8630
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Mailing Address
SALLY ELLSWORTH
20813 LIBERTY LN
BEND, OR 97701-8596
Phone number:
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