| NPI | 1629398433 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA L WILSON Owner 413-788-0100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RA0401X Internal Medicine, Addiction Medicine |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 103TA0400X Psychologist, Addiction (Substance Use Disorder) | |
| 104100000X Social Worker | |
| 2084A0401X Psychiatry & Neurology, Addiction Medicine | |
| Enumeration Date | 2010-06-03 |
| Last Update Date | 2010-06-09 |