| NPI | 1649485590 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN CZERNICKA Psychologist 617-835-8175 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA 2731) |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2008-11-21 |