Individual
ELYSIA HUMPHREY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
500 W CUMMINGS PARK, WOBURN, MA 01801-6503
(781) 932-0970
Mailing address
29 CAMERON AVE, SOMERVILLE, MA 02144-2429
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
07/31/2014
Last updated
07/31/2014
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