| NPI | 1013416387 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIANA IGBINOSUN Np 617-203-2009 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2018-02-01 |
| Last Update Date | 2024-03-12 |