| NPI | 1568120343 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTHONY N WAITHANJI Owner: Managing Director 508-524-0323 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 2084B0040X Psychiatry & Neurology, Behavioral Neurology & Neuropsychiatry | |
| 251S00000X | |
| Enumeration Date | 2021-11-29 |
| Last Update Date | 2023-01-24 |