| NPI | 1215618210 |
|---|---|
| Doing Business As | ELLIE MENTAL HEALTH-ANDOVER |
| Entity Type | Organization |
| Authorized Contact | NICOLE FRANCES FAGONE Clinical Director 617-256-7616 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2023-07-31 |
| Last Update Date | 2023-07-31 |