| NPI | 1255086153 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA JANE MAURIER Provider 603-371-3435 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2022-02-18 |
| Last Update Date | 2024-02-15 |