| NPI | 1609360510 |
|---|---|
| Doing Business As | CRANIOFACIAL PAIN CLINIC-BEHAVIORAL HEALTH |
| Entity Type | Organization |
| Authorized Contact | LISA GATELY Credentialing Manager 617-636-6505 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist |
| Enumeration Date | 2018-06-15 |
| Last Update Date | 2018-06-15 |