| NPI | 1114348166 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUDITH VANDERRYN Owner/Sole Proprietor 802-651-8999 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: CO 2051) |
| Enumeration Date | 2013-12-18 |
| Last Update Date | 2023-12-18 |