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Organization
UNIVERSITY OF VERMONT AND STATE AGRICULTURAL COLLEGE
Active
Organization
UNIVERSITY OF VERMONT AND STATE AGRICULTURAL COLLEGE
Active
Other names
Eleanor M. Luse Center
Organization subpart
No
Provider details
NPI number
Authorized official
MOIRA MULLIGAN CCC-SLP (CLINIC DIRECTOR)
(802) 656-0202
Entity
Organization
Contact information
Practice address
489 MAIN ST, POMEROY HALL, BURLINGTON, VT 05405-1709
(802) 656-3861
(802) 656-2528
Mailing address
489 MAIN ST, POMEROY HALL, BURLINGTON, VT 05405-1709
(802) 656-3861
(802) 656-2528
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
—
NULL
231H00000X
Audiologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00002672
BCBS
—
05
—
1005859
—
VT
01
—
64008
MVP
—
Enumeration date
02/12/2007
Last updated
01/21/2010
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