| NPI | 1891167318 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICKY JEAN LOCKE President 781-990-3290 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MA 9330) |
| Additional Taxonomies | 251S00000X (Licence: MA 9330) |
| Enumeration Date | 2015-10-23 |
| Last Update Date | 2015-10-23 |