Organization
DANA ELLSMORE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DANA H. ELLSMORE (CLINICIAN)
(617) 661-5700
Entity
Organization
Contact information
Practice address
260 BEACON ST, SOMERVILLE, MA 02143-3534
(617) 661-5700
Mailing address
260 BEACON ST, SOMERVILLE, MA 02143-3534
(617) 661-5700
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
03/23/2012
Last updated
03/23/2012
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