| NPI | 1558599811 |
|---|---|
| Former Name | KATHLEEN ANNA TRESSEL ELLSWORTH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149.012998) |
| Enumeration Date | 2009-06-25 |
| Last Update Date | 2014-02-06 |