| NPI | 1285687616 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JON W ASSELIN COO 802-872-4326 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 207R00000X Internal Medicine | |
| 208000000X Pediatrics | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2024-01-30 |