| NPI | 1356723514 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE NICOLE HARRIS Licensed Professional Counselor 802-922-0161 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: IL 178011026) |
| Enumeration Date | 2015-06-24 |
| Last Update Date | 2015-06-24 |