| NPI | 1881978971 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FREDERICK PAUL HORAN Director 508-668-6053 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA 4743) |
| Enumeration Date | 2011-10-06 |
| Last Update Date | 2022-01-06 |