| NPI | 1750453536 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GERALD W LEWIS Co Director 508-872-1650 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2006-11-15 |
| Last Update Date | 2020-08-22 |