| NPI | 1013419381 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELEANOR KENT FULTON Director/Owner 508-785-5518 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MA 7814) |
| Enumeration Date | 2018-03-02 |
| Last Update Date | 2018-03-02 |