| NPI | 1760573034 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN L MONTGOMERY Partner/Manager 508-362-4250 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MA 105247) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MA 111611) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MA 33934) | |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2020-08-22 |