| NPI | 1235396342 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY BRADLEY Owner 617-698-0998 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MA 46623) | |
| Enumeration Date | 2008-05-19 |
| Last Update Date | 2008-05-19 |