| Doctor Name: | MS. ELLEN KOSSE WATERS |
| NPI Number: | 1306945225 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LICSW |
| License Number: | 102972 |
| Business Practice Address: | 257 Ayer Road Harvard, MA - 01451 |
| Business Phone Number: | 9787724457 |
| Business Fax Number: | 9787727107 |
| Mailing Address: | 257 Ayer Rd, HARVARD |
| State: | MA |
| Postal Code: | 014511108 |
| Phone Number: | 9787724457 |
| Fax Number: | 9787727107 |
| NPI Enumeration Date: | 09/21/2006 |
| NPI Last Update Date: | 11/14/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 102972 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |