| NPI | 1831630235 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER A Y JOHNSTON Sole Proprietor 617-699-3101 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CT 2205) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MA 7570) |
| Enumeration Date | 2017-03-17 |
| Last Update Date | 2019-03-08 |