| NPI | 1447643762 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK SAWYER KINCHLA President 978-604-5561 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MA 10081) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MA 10081) |
| 103TA0400X Psychologist Addiction (Substance Use Disorder) (Licence: MA 10081) | |
| 103TB0200X Psychologist Cognitive & Behavioral (Licence: MA 10081) | |
| 103TE1100X Psychologist Exercise & Sports (Licence: MA 10081) | |
| 103TH0004X Psychologist Health (Licence: MA 10081) | |
| 103TH0100X Psychologist Health Service (Licence: MA 10081) | |
| Enumeration Date | 2015-03-11 |
| Last Update Date | 2019-08-28 |