| NPI | 1316701725 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SIENNA FONTAINE Clinician And Owner 802-318-2993 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| Enumeration Date | 2024-02-07 |
| Last Update Date | 2024-04-16 |