| NPI | 1578862272 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LESHELLE WOODARD Psychologist 617-552-5124 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA 8649) |
| Additional Taxonomies | 104100000X Social Worker (Licence: MA 115940) |
| Enumeration Date | 2011-03-21 |
| Last Update Date | 2018-07-23 |