| NPI | 1487064713 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARA LINDSAY THOMASON Business Owner 774-419-1041 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MA 9192) |
| Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: MA 9192) |
| 103TC0700X Psychologist, Clinical (Licence: MA 9192) | |
| Enumeration Date | 2014-05-08 |
| Last Update Date | 2014-05-08 |