| NPI | 1962210872 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARISSA GENDUSO Licensed Mental Health Clinician 802-750-1511 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2024-12-23 |
| Last Update Date | 2024-12-23 |