| NPI | 1285250795 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN BLAISDELL Owner 781-435-7941 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101Y00000X Counselor |
| 103TC1900X Psychologist, Counseling | |
| 1041C0700X Social Worker, Clinical | |
| 106H00000X Marriage & Family Therapist | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2020-06-20 |
| Last Update Date | 2022-09-07 |