| NPI | 1154046696 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LESLIE M CONROY Owner 802-865-3450 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2022-10-06 |
| Last Update Date | 2022-10-06 |