NPI | 1023623352 |
---|---|
Entity Type | Organization |
Authorized Contact | DAVID BUCKLEY Owner 617-302-7102 |
Organization Subpart ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
Enumeration Date | 2020-09-14 |
Last Update Date | 2020-09-14 |