TYAN R ELLSWORTH

ATLANTIC, IA
NPI1366684722
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: IA  95005)
Enumeration Date2009-04-01
Last Update Date2015-11-16
Business Address
-- TYAN R ELLSWORTH CADC
1500 E 10TH ST
ATLANTIC, IA 50022-1935
Phone number: 712-243-5091
Mailing Address
-- TYAN R ELLSWORTH CADC
1500 E 10TH ST
ATLANTIC, IA 50022-1935
Phone number: 712-243-5091
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