| NPI | 1477822823 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT W. DAVIS Director 413-835-0520 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA 7324) |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MA 8195) |
| 103TH0004X Psychologist, Health (Licence: MA 7324) | |
| Enumeration Date | 2011-12-14 |
| Last Update Date | 2011-12-14 |