| NPI | 1972909299 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY JOHNSON MARICLE Owner 508-964-2029 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MA 6004) |
| Enumeration Date | 2014-11-13 |
| Last Update Date | 2014-11-13 |