Individual
ELISA MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
572 ROUTE 28, WEST YARMOUTH, MA 02673-4909
(508) 775-0719
Mailing address
500 VICTORY ROAD, SOUTH SHORE MENTAL HEALTH, QUINCY, MA 02171
(617) 847-1950
(617) 774-1490
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LCSW 210979
MA
Other
Enumeration date
08/16/2006
Last updated
07/08/2007
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