Individual
TANIA ELHOUSSAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
288 GROVE ST, WORCESTER, MA 01605-3934
(774) 525-1611
Mailing address
288 GROVE ST, WORCESTER, MA 01605-3934
(774) 525-1611
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
22904
MA
Other
Enumeration date
09/06/2023
Last updated
09/06/2023
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