| NPI | 1003200536 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANDY LOGAN Practice Manager 508-830-0012 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MA 9159) |
| Enumeration Date | 2015-03-23 |
| Last Update Date | 2015-03-23 |