| NPI | 1821669805 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT MARTIN DUWORS Director 802-876-7613 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical |
| Enumeration Date | 2021-07-09 |
| Last Update Date | 2021-07-09 |