Individual
CORINNE ALYSE ELLEFSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1300 OLD PLANK RD, MAYFIELD, PA 18433-1973
(570) 281-6222
Mailing address
208 E HARFORD ST STE 3, MILFORD, PA 18337-1042
(845) 346-6024
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
SW136306
PA
Other
Enumeration date
07/18/2019
Last updated
07/19/2019
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