| NPI | 1396471892 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELIQUE PARKS Clinical Mental Health Counselor 802-881-9519 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2022-07-27 |
| Last Update Date | 2022-07-27 |