| NPI | 1427468107 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GENEVOR MONELL Clinician 508-386-6155 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101Y00000X Counselor |
| Enumeration Date | 2014-05-02 |
| Last Update Date | 2014-05-02 |