| NPI | 1922346212 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELENA MEDVEDOVSKI-KHANUKAEV Owner/Clinical Social Worker 617-669-6059 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MA 113723) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MA 218572) |
| Enumeration Date | 2013-01-22 |
| Last Update Date | 2013-08-30 |