| NPI | 1902227275 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PETER W MORAN Director 774-253-1573 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA 3358) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MA 7013) |
| 101YM0800X Counselor, Mental Health (Licence: MA 7534) | |
| 101YM0800X Counselor, Mental Health (Licence: MA 6209) | |
| 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: MA 239917) | |
| 103TC0700X Psychologist, Clinical (Licence: MA 7497) | |
| 363L00000X Nurse Practitioner (Licence: MA rn198309) | |
| Enumeration Date | 2014-01-03 |
| Last Update Date | 2014-01-06 |