Ellison, Octavia
Ellison, Octavia is an individual health care provider with primary practice located at 619 S Marion Ave , Lake City FL 32025-5808. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Recreation Therapist, which is considered as her primary health care specialty. Ellison, Octavia can be contacted via phone (386) 755-3016.Contact Information
Primary practice address
619 S Marion Ave
Lake City FL 32025-5808
Phone: (386) 755-3016
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Recreation Therapist | 225800000X |
Profile Details
| NPI number | 1073180808 |
|---|---|
| LBN Legal business name | Ellison, Octavia |
| Credentials | CRC, CTRS |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 9th, 2021 |
| Last updated | Jun 9th, 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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