| NPI | 1477899920 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WHITNEY BADE Head Of Credentialing 617-326-3751 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NY 004239) |
| Enumeration Date | 2013-01-02 |
| Last Update Date | 2013-01-02 |