| NPI | 1275694234 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VIRGINIA A BYRON Administrative Director 617-734-2007 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA 3098) |
| Enumeration Date | 2006-12-13 |
| Last Update Date | 2020-08-22 |