| NPI | 1659785186 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONNA MENNETO Business Manager 802-379-5821 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0802X Psychiatry & Neurology, Addiction Psychiatry |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 207Q00000X Family Medicine | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2014-06-12 |
| Last Update Date | 2014-07-17 |