NPI | 1174657597 |
---|---|
Entity Type | Organization |
Authorized Contact | STEVEN R. LEWIS Clinical Psychologist 802-651-7637 |
Organization Subpart ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: VT 048-0000277) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: VT 068-0000040) |
Enumeration Date | 2007-03-15 |
Last Update Date | 2008-09-10 |