| NPI | 1386118099 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KARA MARIE FITZGERALD Manager 781-478-2535 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist |
| Additional Taxonomies | 103T00000X Psychologist |
| 103TA0700X Psychologist, Adult Development & Aging | |
| 103TB0200X Psychologist, Cognitive & Behavioral | |
| 103TC0700X Psychologist, Clinical | |
| 103TM1800X Psychologist, Intellectual & Developmental Disabilities | |
| 103TR0400X Psychologist, Rehabilitation | |
| 103TC1900X Psychologist, Counseling | |
| Enumeration Date | 2019-01-15 |
| Last Update Date | 2019-01-15 |