| NPI | 1063932424 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACY EGGSWARE Owner 802-494-4040 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 261QM0801X |
| Enumeration Date | 2017-06-26 |
| Last Update Date | 2024-01-02 |