| NPI | 1134506504 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHERYL A BOWEN Counselor 802-673-4907 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: VT 038.0057723) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: VT 000023) |
| Enumeration Date | 2015-05-05 |
| Last Update Date | 2015-05-05 |