| NPI | 1629524327 |
|---|---|
| Doing Business As | PEDIATRIC BUILDING BLOCKS |
| Entity Type | Organization |
| Authorized Contact | TREVENA MOORE Member 617-306-2065 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: VI 1229) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: VI 2351041B) |
| Enumeration Date | 2016-09-01 |
| Last Update Date | 2016-09-12 |