| NPI | 1407395502 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DORA SHALTS-LASTRA Owner/Counselor 617-209-7957 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: MA 9251) |
| Enumeration Date | 2017-02-22 |
| Last Update Date | 2017-02-22 |