Individual
MS. ELAINE RUTH ENOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LADC
Contact information
Practice address
10 MEADOWBROOK RD, BROCKTON, MA 02301-7122
(508) 472-4482
(508) 742-4495
Mailing address
10 MEADOWBROOK RD, BROCKTON, MA 02301-7122
(978) 302-5591
(508) 742-4495
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
17541
MA
Other
Enumeration date
07/13/2020
Last updated
07/13/2020
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