| NPI | 1952616120 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARL FREEMAN GUSTAFSON Licenced Clinical Psychologist 508-362-1180 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA MA8060) |
| Enumeration Date | 2010-08-12 |
| Last Update Date | 2013-09-06 |