Individual
ELIZABETH TALEAS SOUTHALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
720 WASHINGTON ST STE 603, HANOVER, MA 02339-2476
(617) 306-2748
Mailing address
PO BOX 934, HANOVER, MA 02339-0934
(617) 552-5124
(888) 317-2641
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
212052
MA
Other
Enumeration date
12/11/2007
Last updated
10/19/2021
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