Individual
ELISSA MARIE TUBERGEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSWA
Contact information
Practice address
212 ENSTONE CT, HILLSBOROUGH, NC 27278-9841
(651) 212-0640
Mailing address
212 ENSTONE CT, HILLSBOROUGH, NC 27278-9841
(651) 212-0640
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
P015332
NC
Other
Enumeration date
04/05/2021
Last updated
04/05/2021
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