| NPI | 1902976798 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DETTA HALPIN Credentialing COO Rdinator 781-792-4191 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 103T00000X Psychologist |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2008-04-20 |