| NPI | 1972479582 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROLYN GAECKLE Owner And Provider 802-216-8480 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Enumeration Date | 2025-10-13 |
| Last Update Date | 2025-10-13 |