| NPI | 1174180210 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK CARLSON CEO 978-927-7070 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| 2080P0006X Pediatrics Developmental - Behavioral Pediatrics | |
| 225100000X Physical Therapist | |
| 225X00000X Occupational Therapist | |
| Enumeration Date | 2019-05-23 |
| Last Update Date | 2019-05-23 |