| NPI | 1588927495 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ETHAN L SEIDMAN Director 617-388-7920 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MA 8218) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MA 8218) |
| Enumeration Date | 2012-06-18 |
| Last Update Date | 2013-01-24 |