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Individual

DOMINIQUE ELLIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
50 REDFIELD ST, SUITE 300, DORCHESTER, MA 02122-3630
(617) 455-9102
Mailing address
50 REDFIELD ST, SUITE 300, DORCHESTER, MA 02122-3630

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary

Other

Enumeration date
03/01/2017
Last updated
03/01/2017
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Product
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