| NPI | 1275191199 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNKATRINE LIEGMANN GATES Manger/Owner 617-800-9469 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2019-06-05 |
| Last Update Date | 2022-05-02 |