| NPI | 1629770193 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBBIE BURWICK Insuranc/Credentialing Specialist 774-666-0092 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| Enumeration Date | 2023-03-20 |
| Last Update Date | 2023-03-20 |