| NPI | 1861919755 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA JOHNSTON Therapist 508-802-4199 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MA 8154) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MA 2366) |
| Enumeration Date | 2017-08-23 |
| Last Update Date | 2020-03-21 |