MARK DALTON ELLIS

TWIN FALLS, ID
NPI1336401710
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy1041C0700X Social Worker Clinical
(Licence: ID  LCSW-32484)
Enumeration Date2012-06-12
Last Update Date2013-12-04
Business Address
MR. MARK DALTON ELLIS LMSW
1418 FILLMORE ST
TWIN FALLS, ID 83301-3380
Phone number: 208-735-2237
Mailing Address
MR. MARK DALTON ELLIS LMSW
1418 FILLMORE ST
TWIN FALLS, ID 83301-3380
Phone number: 208-735-2237
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