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General NPI Number Information
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NPI Number | 1194890111
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Entity Type | Individual
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Provider Name | ELLEN A ALFARO
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Gender | Female
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Dates
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Enumeration Date | 11/22/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 154 E CENTRAL ST SUITE 205
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City | NATICK
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State | MA
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Zip | 01760-3644
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Country | US
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Telephone | 508-651-3845
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Fax |
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Provider Business Mailing Address
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Address Line | 6 ABBOTT RD
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City | NATICK
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State | MA
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Zip | 01760-1947
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Country | US
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Telephone | 508-650-9582
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 1379
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License Number State | MA
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