| NPI | 1609354299 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE NICKERSON Owner 978-903-2030 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MA 121121) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NH 2096) |
| Enumeration Date | 2018-08-06 |
| Last Update Date | 2018-08-21 |