| NPI | 1548701857 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHLEY KOCH CFO 617-562-5359 |
| Organization Subpart ? | No |
| Primary Taxonomy | 104100000X Social Worker |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| 103G00000X Clinical Neuropsychologist | |
| 103T00000X Psychologist | |
| 103TC0700X Psychologist, Clinical | |
| Enumeration Date | 2017-03-20 |
| Last Update Date | 2017-03-20 |