| NPI | 1922569474 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL JAY WEINBERG Owner 617-764-9271 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YM0800X Counselor Mental Health | |
| 101YP2500X Counselor Professional | |
| 103T00000X Psychologist | |
| Enumeration Date | 2019-03-27 |
| Last Update Date | 2020-08-26 |