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 |