| NPI | 1053747659 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELINDA EILEEN KULISH President 617-661-1100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: MA 7822) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MA 7822) |
| Enumeration Date | 2013-09-16 |
| Last Update Date | 2013-09-16 |