Individual
JODI ELISE ELLSWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW-C
Contact information
Practice address
2 ELLSWORTH DR, LAVALE, MD 21502-4757
(443) 912-6153
Mailing address
10100 COUNTRY CLUB RD SE, CUMBERLAND, MD 21502-8339
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
12713
MD
Other
Enumeration date
12/17/2018
Last updated
12/17/2018
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