| NPI | 1316368749 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GILLIAN CAROL GALEN Clinical Director 617-290-9432 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MA 9159) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MA 2353) |
| Enumeration Date | 2014-01-03 |
| Last Update Date | 2014-01-03 |