| NPI | 1386039105 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH N BEAUPRE Practice Manager 617-657-9838 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: RI MHC00668) |
| Enumeration Date | 2015-03-30 |
| Last Update Date | 2015-10-22 |