| NPI | 1922164854 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN RODERICK STAHL Manager 508-822-1690 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MA 158354) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: MA 974343) |
| 101Y00000X Counselor (Licence: MA 4317) | |
| 103T00000X Psychologist (Licence: MA 1830) | |
| 103T00000X Psychologist (Licence: MA 7981) | |
| 104100000X Social Worker (Licence: MA 102138) | |
| 104100000X Social Worker (Licence: MA 1019475) | |
| 104100000X Social Worker (Licence: MA 1026603) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MA 27329) | |
| Enumeration Date | 2006-12-28 |
| Last Update Date | 2025-09-11 |