Individual
AMY ELLENTUCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
50 FR MORISSETTE BLVD, LOWELL, MA 01852-1037
(781) 640-8094
Mailing address
50 FR MORISSETTE BLVD, LOWELL, MA 01852-1037
(789) 275-6320
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1016302
MA
Other
Enumeration date
08/31/2018
Last updated
08/31/2018
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