| NPI | 1013264498 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | C. EMMA BURROUS Owner 802-657-4042 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: VT 048-0000905) |
| Enumeration Date | 2012-08-05 |
| Last Update Date | 2012-08-05 |