Provider Demographics
NPI:1730264524
Name:OVERTON, ELLA K
Entity type:Individual
Prefix:MRS
First Name:ELLA
Middle Name:K
Last Name:OVERTON
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:ELLA
Other - Middle Name:KEMP
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:53 E WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:HORNELL
Mailing Address - State:NY
Mailing Address - Zip Code:14843
Mailing Address - Country:US
Mailing Address - Phone:607-776-0325
Mailing Address - Fax:607-776-9366
Practice Address - Street 1:6838 INDUSTRIAL PK RD
Practice Address - Street 2:
Practice Address - City:BATH
Practice Address - State:NY
Practice Address - Zip Code:14810
Practice Address - Country:US
Practice Address - Phone:607-776-0325
Practice Address - Fax:607-776-9366
Is Sole Proprietor?:No
Enumeration Date:2006-10-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225C00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Counselor