Individual
ELLEN J PELLETIER
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MA LP LICSW
Contact information
Practice address
713 ANDERSON AVE, ST CLOUD, MN 56303
(320) 229-3761
(320) 229-3763
Mailing address
1406 6TH AVE N, ST CLOUD, MN 56303
(320) 251-2700
(320) 656-7026
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
12925
MN
Other
Enumeration date
05/09/2006
Last updated
07/08/2007
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