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Organization

AHIMSA CENTER FOR GROWTH AND DEVELOPMENT

Active
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Organization

AHIMSA CENTER FOR GROWTH AND DEVELOPMENT

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. JEFFREY BRADLEY LICSW (OWNER)
(617) 698-0998
Entity
Organization

Contact information

Practice address
464 GRANITE AVE, SUITE 25, MILTON, MA 02186-5625
(617) 698-0991
(617) 698-1274
Mailing address
464 GRANITE AVE, SUITE 25, MILTON, MA 02186-5625
(617) 698-0991
(617) 698-1274

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
1041C0700X
Clinical Social Worker
Primary
2084P0800X
Psychiatry Physician
46623
MA

Other

Enumeration date
05/19/2008
Last updated
05/19/2008
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