| NPI | 1578341681 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EMILY BODNER Owner 617-312-7737 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2023-09-19 |
| Last Update Date | 2023-09-19 |