| NPI | 1497030795 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONNA LYDER Clinician/Owner 617-232-4570 |
| Organization Subpart ? | No |
| Primary Taxonomy | 364SP0808X Clinical Nurse Specialist Psychiatric/Mental Health (Licence: MA RN217927) |
| Enumeration Date | 2011-10-18 |
| Last Update Date | 2011-10-18 |