| NPI | 1568127157 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLARENCE THEODORE DENNIS Psychiatric Nurse Practitioner 617-413-6618 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2021-11-08 |
| Last Update Date | 2021-11-08 |