| NPI | 1750747762 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COURTNEY BOHEN Owner 802-356-1478 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: VT 0890056470) |
| Enumeration Date | 2016-01-06 |
| Last Update Date | 2016-01-06 |