| NPI | 1568772184 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA M HOSKINS Clinical Director 888-574-0353 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: VT 0680000377) |
| Enumeration Date | 2010-10-16 |
| Last Update Date | 2010-10-16 |