| NPI | 1134271695 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATE VANDEN BERGH Part Owner 802-223-7364 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: VT 089-0000770) |
| Enumeration Date | 2007-01-17 |
| Last Update Date | 2012-11-12 |