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Individual
JOHN T MORAN
Active
Individual
JOHN T MORAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA, LADC
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
000169
VT
103T00000X
Psychologist
000169
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
29256
BLUE CROSS D&A
VT
01
—
49392
BLUE CROSS
VT
Enumeration date
03/27/2007
Last updated
07/10/2007
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