Individual
ELLEN H THEODORES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
153B PARK ROWE, BRUNSWICK, ME 04011
(207) 245-5087
Mailing address
153B PARK ROWE, BRUNSWICK, ME 04011
(207) 245-5087
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LC14014
ME
Other
Enumeration date
11/08/2010
Last updated
04/19/2013
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