| NPI | 1811232853 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANN MARIE E. IDE Psychotherapist 617-875-6031 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MA 115559) |
| Enumeration Date | 2012-12-03 |
| Last Update Date | 2012-12-03 |