NPI | 1104570019 |
---|---|
Entity Type | Organization |
Authorized Contact | JESSICA BOYATT Owner/President 617-388-9306 |
Organization Subpart ? | No |
Primary Taxonomy | 103G00000X Clinical Neuropsychologist |
Additional Taxonomies | 103TC0700X Psychologist, Clinical |
Enumeration Date | 2022-02-09 |
Last Update Date | 2022-02-09 |