| NPI | 1851980544 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAITLYN DEFIORE Director Client Operations 508-340-1419 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent |
| 133V00000X Dietitian, Registered | |
| Enumeration Date | 2021-01-16 |
| Last Update Date | 2021-01-16 |