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Individual
ELLEN WALTMAN
Active
Individual
ELLEN WALTMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
002290
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004040564
—
CT
Enumeration date
10/14/2016
Last updated
10/14/2016
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