Individual
RUTH MITTELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
377 HURON AVE, CAMBRIDGE, MA 02138-6832
(857) 998-9287
Mailing address
377 HURON AVE, CAMBRIDGE, MA 02138-6832
(857) 998-9287
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
1016607
MA
104100000X
Social Worker
10166607
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1016607
CURRENTLY RETIRED
MA
Enumeration date
09/26/2018
Last updated
09/26/2018
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