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General NPI Number Information
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NPI Number | 1225744907
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Entity Type | Organization
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Legal Business Name | SIMPLY ELLEN HOLISTIC SERVICES LLC
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Dates
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Enumeration Date | 01/26/2023
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Last Update Date | 01/26/2023
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Provider Practice Location Address
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Address Line | 112 S WESTMORELAND AVE APT 9
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City | LOS ANGELES
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State | CA
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Zip | 90004-6012
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Country | US
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Telephone | 704-453-9647
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Fax |
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Provider Business Mailing Address
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Address Line | 112 S WESTMORELAND AVE APT 9
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City | LOS ANGELES
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State | CA
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Zip | 90004-6012
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Country | US
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Telephone | 704-453-9647
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Fax |
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Authorized Official
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Title or Position | FULL-SPECTRUM DOULA
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Name | MS. ELLEN ASHLEY BRANCH
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Credential | FSD, RYT, CLES
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Telephone | 704-453-9647
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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