Provider Demographics
NPI:1114992039
Name:PERRELLA, ELLEN D (ATC, LAT, CSCS)
Entity Type:Individual
Prefix:MS
First Name:ELLEN
Middle Name:D
Last Name:PERRELLA
Suffix:
Gender:F
Credentials:ATC, LAT, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 CHILEAB RD
Mailing Address - Street 2:
Mailing Address - City:S HADLEY
Mailing Address - State:MA
Mailing Address - Zip Code:01075-1220
Mailing Address - Country:US
Mailing Address - Phone:413-538-2640
Mailing Address - Fax:413-538-2183
Practice Address - Street 1:50 COLLEGE ST.
Practice Address - Street 2:MOUNT HOLYOKE COLLEGE
Practice Address - City:S. HADLEY
Practice Address - State:MA
Practice Address - Zip Code:01075-1431
Practice Address - Country:US
Practice Address - Phone:413-538-2640
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2332255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer