| NPI | 1033672100 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KERRIE JONGENEELEN Clinical Psychologist 617-372-5653 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical |
| 103TC1900X Psychologist, Counseling | |
| 103TF0000X Psychologist, Family | |
| Enumeration Date | 2019-04-07 |
| Last Update Date | 2019-06-11 |