| NPI | 1982311882 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL O'TOOLE Owner 802-497-2187 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 261Q00000X |
| Enumeration Date | 2022-10-31 |
| Last Update Date | 2022-10-31 |