| NPI | 1164166799 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ATHENA P DAVOS Psychiatric Nurse Practitioner 617-417-3885 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2022-04-20 |
| Last Update Date | 2022-04-20 |