| NPI | 1790891422 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA LALIBERTE Practice Manager 508-872-4813 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry |
| Additional Taxonomies | 103TC0700X Psychologist Clinical |
| 1041C0700X Social Worker Clinical | |
| 163WP0807X Registered Nurse Psychiatric/Mental Health, Child & Adolescent | |
| 163WP0808X Registered Nurse Psychiatric/Mental Health | |
| 163WP0809X Registered Nurse Psychiatric/Mental Health, Adult | |
| 2084P0800X Psychiatry & Neurology Psychiatry | |
| Enumeration Date | 2006-08-23 |
| Last Update Date | 2011-11-28 |