| NPI | 1225706195 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHLEY MARIE MCCULLOUGH Licensed Clinical Social Worker 802-734-5864 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2021-09-03 |
| Last Update Date | 2021-09-03 |