| NPI | 1053048793 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTA REINCKE Clinical Director 802-735-7934 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical |
| Additional Taxonomies | 1041C0700X Social Worker Clinical |
| Enumeration Date | 2022-08-03 |
| Last Update Date | 2022-08-03 |