| NPI | 1821440637 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIE HEIM JACKSON Psychologist/ Owner 617-538-6856 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA 9213) |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MA 9213) |
| Enumeration Date | 2016-07-05 |
| Last Update Date | 2016-07-05 |