| NPI | 1740501071 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA PEZZULICH Owner 802-442-3520 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: VT 0480000729) |
| Enumeration Date | 2010-06-22 |
| Last Update Date | 2010-06-22 |