| NPI | 1508106238 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARISSA LYNNE PEIFER Owner 617-213-0747 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA 9248) |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2013-02-16 |
| Last Update Date | 2021-02-18 |