Most Relevant Information
Provider Data
| NPI Number: | 1003526641 |
| Provider Name: | MACY ELLETT |
| Entity Type: | Individual |
| Taxonomy Code: | 235Z00000X |
| Specialty: | Speech-Language Pathologist |
| License Number: | 22008315A |
Most Important Dates
| Enumeration Date: | 12/05/2022 |
| Last Updated: | 12/05/2022 |
Provider Practice Location
1813 WILLOW ST STE 4D
VINCENNES
IN
475914279
Practice Location Phone/Fax
| Phone: | 8128877056 |
| Fax: |
Provider Mailing Location
1080 W COUNTY ROAD 850 S
CARLISLE
IN
478388377
Provider Mailing Phone/Fax
| Phone: | 8128877056 |
| Fax: |