| NPI | 1518387950 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE TAVERAS CEO, Behavioral Therapist 617-595-7044 |
| Organization Subpart ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: MA 86013220) |
| Additional Taxonomies | 133N00000X Nutritionist (Licence: MA 3632) |
| Enumeration Date | 2014-04-24 |
| Last Update Date | 2014-04-24 |