Individual
MS. ELLEN LOUISE KORNETSKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S.W., L.C.S.W.
Contact information
Practice address
75 WASHINGTON AVE, PORTLAND, ME 04101-2665
(207) 772-4110
(207) 761-0748
Mailing address
75 WASHINGTON AVE, PORTLAND, ME 04101-2665
(207) 772-4110
(207) 761-0748
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LC5740
ME
Other
Enumeration date
05/26/2010
Last updated
05/26/2010
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