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General NPI Number Information
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NPI Number | 1932824430
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Entity Type | Organization
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Legal Business Name | GREATER BOSTON ASSESSMENT & TREATMENT, LLC
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Dates
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Enumeration Date | 10/06/2022
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Last Update Date | 10/06/2022
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Provider Practice Location Address
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Address Line | 747 MAIN ST STE 228
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City | CONCORD
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State | MA
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Zip | 01742-3302
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Country | US
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Telephone | 617-651-2207
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 300730
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City | JAMAICA PLAIN
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State | MA
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Zip | 02130-0007
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | FOUNDER / CLINICAL PSYCHOLOGIST
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Name | DR. KIRSTIN BIRTWELL
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Credential | PHD
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Telephone | 617-651-2207
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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