Ellis, Samantha Jo
Ellis, Samantha Jo is an individual health care provider with primary practice located at 1530 Woodfield Creek Dr Apt 205 , Wake Forest NC 27587-4758. She recently has only one registered license in Behavioral Health & Social Service Providers / Behavior Technician, which is considered as her primary health care specialty. Ellis, Samantha Jo can be contacted via phone (919) 889-4990.Contact Information
Primary practice address
1530 Woodfield Creek Dr Apt 205
Wake Forest NC 27587-4758
Phone: (919) 889-4990
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Behavior Technician | 106S00000X |
Profile Details
| NPI number | 1841959533 |
|---|---|
| LBN Legal business name | Ellis, Samantha Jo |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 10th, 2021 |
| Last updated | Dec 10th, 2021 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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