| NPI | 1841969375 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALLISON DENICE TABLES Counselor 617-834-9969 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2021-09-08 |
| Last Update Date | 2024-07-30 |