| NPI | 1104065853 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHARON A. CHIRBAN Director 978-337-6095 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MA 6775) |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MA 6775) |
| 103TE1100X Psychologist, Exercise & Sports (Licence: MA 6775) | |
| Enumeration Date | 2009-02-19 |
| Last Update Date | 2009-02-19 |