| NPI | 1952708216 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYNN MARIE CORBETT Owner/President 774-269-8028 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: MA 1-05-2179) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MA 5086) |
| Enumeration Date | 2014-12-01 |
| Last Update Date | 2014-12-01 |