| NPI | 1144080326 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL EDWARD LAWRIE Owner Member 802-417-2039 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2024-03-22 |
| Last Update Date | 2024-03-30 |