Individual
BETH ELLSWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A., CCC, SLP
Contact information
Practice address
85 MIDDLE RD, CUMBERLAND, ME 04021-3707
(207) 829-8007
(207) 829-8008
Mailing address
85 MIDDLE RD, CUMBERLAND, ME 04021-3707
(207) 829-8007
(207) 829-8008
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP667
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
23494099
—
ME
Enumeration date
05/03/2007
Last updated
07/08/2007
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