Organization
KINGDOM THERAPEUTICS AT SAFE HAVEN FARM, INCORPORATED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTEN WATSON LCMHC (CLINICAL MENTAL HEALTH COUNSELOR)
(802) 673-6476
Entity
Organization
Contact information
Practice address
4095 GORE RD, DERBY, VT 05829-9408
(802) 673-6476
Mailing address
2735 DANE HILL RD, WEST CHARLESTON, VT 05872-9581
(802) 673-6476
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
12/15/2020
Last updated
12/15/2020
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