Individual
BECKY A ELLSWORTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
A.A.S, LCMT
Contact information
Practice address
7 GEORGE ST, PAWTUCKET, RI 02860-4006
(401) 206-1438
Mailing address
77 LEVESQUE ST, WARWICK, RI 02886-0752
(401) 206-1438
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT01068
RI
Other
Enumeration date
02/04/2012
Last updated
02/04/2012
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