NPI 1053860536

Nicole Ellsworth

Practitioner Developmental Therapist Southbridge, MA

Practice location

Address: 486 Worcester St Kennedy Donovan Center, Southbridge, MA 01550-1386
Phone: (508) 367-2338

Registered specialties

Developmental Therapist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 222Q00000X

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Registry record

NPI: 1053860536
Entity type: Individual
Sex (as registered): Female
NPI issued: 26 Sep 2016
Record last updated: 26 Sep 2016

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.