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1760972350
ELLEN PETERSON
ITHACA, NY
NPI
1760972350
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: PR043246-1)
Enumeration Date
2018-05-18
Last Update Date
2018-05-18
Business Address
ELLEN PETERSON LCSW
402 N CAYUGA ST
ITHACA, NY 14850-4291
Phone number: 607-793-4668
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Mailing Address
ELLEN PETERSON LCSW
402 N CAYUGA ST
ITHACA, NY 14850-4291
Phone number: 607-793-4668
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