| NPI | 1982062865 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HAVEN FYFE KIERNAN Owner 617-552-5116 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MA 114084) |
| Enumeration Date | 2016-02-05 |
| Last Update Date | 2016-02-05 |