| NPI | 1083354328 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JILL DUBENDRIS Owner/Provider 508-212-0299 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101Y00000X Counselor |
| Enumeration Date | 2022-04-01 |
| Last Update Date | 2022-05-22 |