| NPI | 1275852097 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RENEE MARIE SORRENTINO Medical Director 617-479-4501 |
| Organization Subpart ? | No |
| Primary Taxonomy | 102L00000X Psychoanalyst (Licence: MA 207842) |
| Enumeration Date | 2010-05-18 |
| Last Update Date | 2012-03-21 |