Provider Demographics
NPI:1972848901
Name:ELLIS, ABBY FOSTER (OTR)
Entity type:Individual
Prefix:MRS
First Name:ABBY
Middle Name:FOSTER
Last Name:ELLIS
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:MS
Other - First Name:ABBY
Other - Middle Name:
Other - Last Name:FOSTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR
Mailing Address - Street 1:1450 VINEWOOD DRIVE
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:IN
Mailing Address - Zip Code:46143
Mailing Address - Country:US
Mailing Address - Phone:724-316-3936
Mailing Address - Fax:
Practice Address - Street 1:1450 VINEWOOD DR
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:IN
Practice Address - Zip Code:46143-7706
Practice Address - Country:US
Practice Address - Phone:866-991-0900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-03
Last Update Date:2024-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist