| NPI | 1518390905 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REBECCA EDDY MUCCILLI Manager 617-750-8222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA 9462) |
| Enumeration Date | 2013-08-20 |
| Last Update Date | 2013-08-20 |