Provider Demographics
NPI:1629542550
Name:BROWNING-LAFFERTY, ELLEN NONE (LMT)
Entity type:Individual
Prefix:
First Name:ELLEN
Middle Name:NONE
Last Name:BROWNING-LAFFERTY
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2020 SPRUCE ST APT 4F
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19103-6572
Mailing Address - Country:US
Mailing Address - Phone:267-240-4397
Mailing Address - Fax:
Practice Address - Street 1:1518 WALNUT ST STE 1000
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19102-3411
Practice Address - Country:US
Practice Address - Phone:267-240-4397
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-14
Last Update Date:2019-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMSG001108225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist