TARA ELLIS

MIDDLETOWN, CT
NPI1861719643
Former NameTARA SMOLLEN
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy1041C0700X Social Worker Clinical
(Licence: CT  007912)
Enumeration Date2010-05-03
Last Update Date2015-03-16
Business Address
TARA ELLIS LCSW
675 MAIN ST
MIDDLETOWN, CT 06457-2718
Phone number: 890-347-6971
Mailing Address
TARA ELLIS LCSW
575 MAIN ST 2ND FLOOR ATTN: CREDENTIALING DPT
MIDDLETOWN, CT 06457-2718
Phone number: 890-347-6971
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