| NPI | 1508037979 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA M KEEFE Billing & Admin Coordinator 603-880-8188 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Additional Taxonomies | 103TP2701X Psychologist, Group Psychotherapy |
| Enumeration Date | 2008-03-13 |
| Last Update Date | 2025-04-04 |