| NPI | 1952921363 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GINA EDSON Licensed Mental Health Counselor 508-982-6795 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2020-04-26 |
| Last Update Date | 2020-10-04 |