Individual
MANDI ELLA CLEGG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BSW, MSW
Contact information
Practice address
680 CENTRE ST, BROCKTON, MA 02302-3308
(508) 941-7498
Mailing address
99 DEPOT ST UNIT B, SOUTH EASTON, MA 02375-1162
(518) 526-0405
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
122817
MA
Other
Enumeration date
06/30/2020
Last updated
06/30/2020
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