| NPI | 1841860020 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLYE HICKEY Director Of Payor And Provider 617-645-2034 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 101YP2500X Counselor, Professional | |
| 106H00000X Marriage & Family Therapist | |
| Enumeration Date | 2021-06-29 |
| Last Update Date | 2021-06-29 |