| NPI | 1164417424 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIM CLARK Owner 617-547-7292 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MA 101057) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: VT 0890000559) |
| Enumeration Date | 2005-09-13 |
| Last Update Date | 2020-08-22 |