NPI | 1427029297 |
---|---|
Entity Type | Organization |
Authorized Contact | MARY JANE COPPOLA Credentialing Coordinator 617-332-2047 |
Organization Subpart ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
Additional Taxonomies | 103TC0700X Psychologist, Clinical |
1041C0700X Social Worker, Clinical | |
163WP0808X Registered Nurse, Psych/Mental Health | |
Enumeration Date | 2006-01-30 |
Last Update Date | 2023-07-26 |