| NPI | 1467990846 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT D WALLACE Owner/Psychotherapist 978-804-4068 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: MA 116999) |
| Enumeration Date | 2017-02-06 |
| Last Update Date | 2017-02-06 |