| NPI | 1497141063 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BILLIE JO HAGEN Owner 802-416-1619 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: VT 0890101573) |
| Enumeration Date | 2015-04-10 |
| Last Update Date | 2025-12-08 |