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Individual

LEE ELLENBERG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
1493 CAMBRIDGE ST, CAMBRIDGE, MA 02139-1047
(617) 665-1606
Mailing address
1493 CAMBRIDGE ST, CAMBRIDGE, MA 02139-1047

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
104213
MA

Other

Enumeration date
12/26/2006
Last updated
07/08/2007
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