| NPI | 1891540803 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HAILEY L LIBBEY Owner 802-881-6905 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2024-04-22 |
| Last Update Date | 2024-04-22 |