Individual
ANN MARIE ELIZABETH IDE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
41 GARRISON RD, BROOKLINE, MA 02445-4445
(617) 277-8107
(617) 734-6385
Mailing address
72 ADDINGTON RD # 2, BROOKLINE, MA 02445-4520
(617) 513-7103
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
115559
MA
Other
Enumeration date
05/10/2010
Last updated
12/03/2012
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