Provider Demographics
NPI:1548387343
Name:PELKUS-ESTERS, LAURETTA ANN
Entity Type:Individual
Prefix:MRS
First Name:LAURETTA
Middle Name:ANN
Last Name:PELKUS-ESTERS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:
Other - Last Name:ESTERS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA
Mailing Address - Street 1:671 E HARTFORD AVE
Mailing Address - Street 2:
Mailing Address - City:UXBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:01569-3205
Mailing Address - Country:US
Mailing Address - Phone:508-278-7010
Mailing Address - Fax:
Practice Address - Street 1:671 E HARTFORD AVE
Practice Address - Street 2:
Practice Address - City:UXBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:01569-3205
Practice Address - Country:US
Practice Address - Phone:508-278-7010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3424101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health