Provider Demographics
NPI:1932705779
Name:LASCELLES, ELLA MARIE
Entity Type:Individual
Prefix:
First Name:ELLA
Middle Name:MARIE
Last Name:LASCELLES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:945 GAGE RD
Mailing Address - Street 2:
Mailing Address - City:PATRIOT
Mailing Address - State:OH
Mailing Address - Zip Code:45658-9300
Mailing Address - Country:US
Mailing Address - Phone:740-645-3021
Mailing Address - Fax:
Practice Address - Street 1:800 SR 325 S
Practice Address - Street 2:
Practice Address - City:THURMAN
Practice Address - State:OH
Practice Address - Zip Code:45685-9731
Practice Address - Country:US
Practice Address - Phone:740-301-5021
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-08
Last Update Date:2020-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide