| NPI | 1851686455 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELE QUINLAN Clinical Supervisor 617-372-3733 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MA 5757) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MA 5757) |
| 101YP2500X Counselor, Professional (Licence: MA 5757) | |
| 103TP0016X Psychologist, Prescribing (Medical) (Licence: MA 75391) | |
| 133V00000X Dietitian, Registered | |
| 133VN1004X Dietitian, Registered, Nutrition, Pediatric | |
| 133VN1006X Dietitian, Registered, Nutrition, Metabolic | |
| Enumeration Date | 2011-06-13 |
| Last Update Date | 2020-04-16 |