| NPI | 1750715108 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK DEYAB Psychotherapist 781-799-3949 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MA 111824) |
| Enumeration Date | 2013-08-21 |
| Last Update Date | 2013-08-21 |