NPI | 1972623874 |
---|---|
Entity Type | Organization |
Authorized Contact | NORI BOKUM President 802-295-7500 |
Organization Subpart ? | No |
Primary Taxonomy | 103T00000X Psychologist (Licence: VT 047-0000634) |
Additional Taxonomies | 103TA0400X Psychologist Addiction (Substance Use Disorder) (Licence: VT 047-0000634) |
103TA0700X Psychologist Adult Development & Aging (Licence: VT 047-0000634) | |
103TB0200X Psychologist Cognitive & Behavioral (Licence: VT 047-0000634) | |
103TC2200X Psychologist Clinical Child & Adolescent (Licence: VT 047-0000634) | |
103TF0000X Psychologist Family (Licence: VT 047-0000634) | |
103TP2701X Psychologist Group Psychotherapy (Licence: VT 047-0000634) | |
Enumeration Date | 2007-04-02 |
Last Update Date | 2020-08-22 |