| NPI | 1033784079 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAL ZUCKERMAN Director Clinic Operations 617-586-0958 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 103TR0400X Psychologist Rehabilitation |
| 1041C0700X Social Worker Clinical | |
| 261QM1300X Clinic/Center Multi-Specialty | |
| 101YM0800X Counselor Mental Health | |
| 103TC0700X Psychologist Clinical | |
| 103TP2701X Psychologist Group Psychotherapy | |
| Enumeration Date | 2021-05-21 |
| Last Update Date | 2021-05-21 |