| NPI | 1013600592 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JADA KHOSLA Medical Director/Co Owner 802-321-3692 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 171100000X Acupuncturist | |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| Enumeration Date | 2023-05-31 |
| Last Update Date | 2024-02-20 |