| NPI | 1316571136 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA KEOVONGSA Owner 781-430-9833 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 133VN1201X Dietitian, Registered, Nutrition, Obesity and Weight Management | |
| Enumeration Date | 2020-03-02 |
| Last Update Date | 2023-09-25 |