| NPI | 1194442038 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAQUANA SMALL Licensed Mental Health Counselor 617-548-9248 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2022-10-21 |
| Last Update Date | 2022-10-21 |