Individual
TERESA ELLSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1443 HARTFORD AVE, JOHNSTON, RI 02919-3224
(401) 273-8100
Mailing address
115 INTERVALE RD, CRANSTON, RI 02910-5245
(508) 685-2899
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
ISW04050
RI
Other
Enumeration date
05/25/2023
Last updated
03/05/2024
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