MRS. Mary Ellen Provencher, LICSW
NPI #1669544235 in Westwood, Massachusetts
Provider Information
- NPI Number
- 1669544235
- Entity Type
- Individual
- Name
- MRS. Mary Ellen Provencher, LICSW
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Social Worker - Clinical
- Credential
- LICSW
- Enumeration Date
- Nov 15, 2006
- Last Updated
- Jul 8, 2007
Practice Location
- Address
- 789 CAPBOARDTREE ST
- Address 2
- HARBOR COUNSELING CENTER
- City
- Westwood
- State
- Massachusetts
- ZIP Code
- 02090
- Phone
- (781) 234-1318
Specialties & Taxonomy Codes
| Specialty |
|---|
| Social Worker - Clinical — Clinical |
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