| NPI | 1982297743 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN M PRAETZ Owner/Provider 617-816-6462 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2021-02-12 |
| Last Update Date | 2021-02-12 |