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General NPI Number Information
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NPI Number | 1346355930
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Entity Type | Individual
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Provider Name | HOWLAND HIRAM ELLIS
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Gender | Male
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Dates
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Enumeration Date | 08/21/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1015 MAR WALT DR
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City | FORT WALTON BEACH
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State | FL
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Zip | 32547-6738
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Country | US
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Telephone | 850-259-9501
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Fax | 850-994-6958
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Provider Business Mailing Address
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Address Line | 5091 SAN MIGUEL ST
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City | MILTON
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State | FL
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Zip | 32583-5630
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Country | US
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Telephone | 850-259-9501
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Fax | 850-994-6958
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | SW2913
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License Number State | FL
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