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Individual
ELLET DURBIN
Active
Individual
ELLET DURBIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
P011318
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P011318
LCSWA
NC
Enumeration date
01/09/2019
Last updated
06/04/2019
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