| NPI | 1578177051 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIELLE LERICHE-FORKEY Clinical Psychologist 802-696-9830 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Enumeration Date | 2020-09-02 |
| Last Update Date | 2020-09-02 |