| NPI | 1447594882 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARISA KOUPERSCHMIDT Owner 617-905-2697 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MA 246627) |
| Enumeration Date | 2012-11-26 |
| Last Update Date | 2025-10-24 |