| NPI | 1235691304 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURIE E ZELAS Provider 508-653-0391 |
| Organization Subpart ? | No |
| Primary Taxonomy | 364SP0808X Clinical Nurse Specialist, Psych/Mental Health |
| Enumeration Date | 2019-04-05 |
| Last Update Date | 2019-04-05 |