| NPI | 1497516371 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN STEVENS Member 603-490-0784 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 225XM0800X Occupational Therapist Mental Health |
| Enumeration Date | 2024-01-18 |
| Last Update Date | 2024-04-29 |