| NPI | 1194886838 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES D. WOLFSON Director 508-366-5909 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MA 3234) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MA 2009) |
| Enumeration Date | 2006-12-13 |
| Last Update Date | 2008-06-14 |