# UNIVERSITY OF VERMONT AND STATE AGRICULTURAL COLLEGE

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Eleanor M. Luse Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1578604310
- **Authorized official:** MOIRA MULLIGAN CCC-SLP (CLINIC DIRECTOR)
- **Authorized official phone:** (802) 656-0202

## Contact information

- **Practice address:** 489 MAIN ST, POMEROY HALL, BURLINGTON, VT 05405-1709
- **Practice address phone:** (802) 656-3861
- **Practice address fax:** (802) 656-2528
- **Mailing address:** 489 MAIN ST, POMEROY HALL, BURLINGTON, VT 05405-1709
- **Mailing address phone:** (802) 656-3861
- **Mailing address fax:** (802) 656-2528

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 231H00000X | Audiologist | — | NULL | Yes |
| 231H00000X | Audiologist | — | — | Yes |

## Other

- **Enumeration date:** 02/12/2007
- **Last updated:** 01/21/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 00002672 | BCBS | — |
| 05 | — | 1005859 | — | VT |
| 01 | — | 64008 | MVP | — |