| NPI | 1093540015 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA VICTORIA SIDERI Owner 617-286-6117 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2024-09-09 |
| Last Update Date | 2024-09-09 |