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 Clinic/Center |
Enumeration Date | 2022-10-31 |
Last Update Date | 2025-01-10 |