| NPI | 1780995332 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACY VANDERMERWE Office Manager 603-580-2337 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA 4233) |
| Enumeration Date | 2010-06-29 |
| Last Update Date | 2010-08-05 |