| NPI | 1851814917 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTEN K ELLARD Psychologist/Sole Member 617-515-9902 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: MA 10310) |
| Enumeration Date | 2017-07-20 |
| Last Update Date | 2017-07-20 |