Individual
DR. ELLEN L SHARENOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
55 LAKE AVE N, UMASS MEMORIAL MEDICAL CTR - CANCER CENTER, WORCESTER, MA 01655-0002
(774) 443-7595
(774) 442-4863
Mailing address
PO BOX 415348, BOSTON, MA 02241-5348
(800) 225-8885
(508) 334-1977
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
7553
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0500500
—
MA
05
—
110022313A
—
MA
Enumeration date
03/27/2006
Last updated
12/03/2020
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