| NPI | 1154925261 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PERRY ELIZABETH BAKER Mental Health Clinician 508-202-0532 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Enumeration Date | 2020-11-30 |
| Last Update Date | 2020-12-04 |