Individual
ELLEN L WIENER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
26 CENTRAL ST, SOMERVILLE, MA 02143-2827
(617) 575-5390
Mailing address
26 CENTRAL ST, SOMERVILLE, MA 02143-2827
(617) 575-5390
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
1030191
MA
Other
Enumeration date
08/24/2007
Last updated
08/24/2007
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