| NPI | 1992850663 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEITH C LEVY Co Director 508-752-5191 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2007-01-24 |
| Last Update Date | 2016-06-28 |