| NPI | 1255944377 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AARON RAKOW Executive Director 802-578-4379 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral |
| Enumeration Date | 2020-08-28 |
| Last Update Date | 2022-08-31 |