Michele Ellsworth

NPI # 

Practice Address:

6608 S West Shore Blvd Apt 2218

Tampa, FL, 33616-1563

Practice Phone:

631-339-2721

Taxonomy Grouping:

Behavioral Health & Social Service Providers

Taxonomy Classification:

Behavior Technician

Taxonomy Code:

106S00000X

Deactivation Date:

2021-12-30T00:00:00.000Z

Deactivation Code:

None

Reactivation Date:

2022-03-14T00:00:00.000Z

Updated by NPPES on 3/14/2022. You can view the original data set for NPI # 1770244808 on the official NPPES website. If the information about this NPI provider/company is outdated you can request updates through the NPPES website. See our FAQ page for more information.

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