Individual
MRS. ELLEN A FORTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ED. CEIS
Contact information
Practice address
38 MARJAC RD, MANSFIELD, MA 02048-3448
(508) 339-9795
Mailing address
38 MARJAC RD, MANSFIELD, MA 02048-3448
(508) 339-9795
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
11/15/2007
Last updated
11/15/2007
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