| NPI | 1639765894 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | CLARENCE T DENNIS Psychiatric Nurse Practitioner 617-413-6618  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health | 
| Enumeration Date | 2020-12-11 | 
| Last Update Date | 2021-11-09 |