| NPI | 1801132337 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON PHILIP OPPENHEIM Owner 617-863-0747 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NH 1274) |
| Enumeration Date | 2013-01-03 |
| Last Update Date | 2019-10-03 |