| NPI | 1962196006 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAM JACTEL CEO 617-209-9153 |
| Organization Subpart ? | No |
| Primary Taxonomy | 171400000X Health & Wellness Coach |
| Additional Taxonomies | 101Y00000X Counselor |
| 103K00000X Behavior Analyst | |
| 103T00000X Psychologist | |
| 103TH0100X Psychologist, Health Service | |
| 104100000X Social Worker | |
| 133N00000X Nutritionist | |
| 133NN1002X Nutritionist, Nutrition, Education | |
| 133V00000X Dietitian, Registered | |
| 171M00000X Case Manager/Care Coordinator | |
| 251S00000X | |
| Enumeration Date | 2023-06-02 |
| Last Update Date | 2023-06-02 |