Individual
MRS. AUDREY R ELY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.I.C.S.W.
Contact information
Practice address
859 WILLARD ST, SUITE 430, QUINCY, MA 02169-7482
(617) 847-1976
(617) 786-9894
Mailing address
47 VILLAGE AVE, APT 204, DEDHAM, MA 02026-4200
(781) 461-1902
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
100333
MA
Other
Enumeration date
07/06/2006
Last updated
07/08/2007
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