| NPI | 1831782408 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GRACE MARGARETE LILIENTHAL Practice Owner 508-319-9369 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2021-02-15 |
| Last Update Date | 2021-02-15 |