| NPI | 1043814288 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREW POTTER Psychologist 617-816-1818 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral |
| 103TC1900X Psychologist, Counseling | |
| 103TC2200X Psychologist, Clinical Child & Adolescent | |
| 103TF0000X Psychologist, Family | |
| 103TS0200X Psychologist, School | |
| Enumeration Date | 2020-11-29 |
| Last Update Date | 2020-11-29 |