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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 CCCSLP (CLINIC DIRECTOR)
(802) 656-0202
Entity
Organization
Contact information
Practice address
489 MAIN STREET, UNIVERSITY OF VERMONT POMEROY HALL, BURLINGTON, VT 05405
(802) 656-3861
(802) 656-2528
Mailing address
489 MAIN STREET, UNIVERSITY OF VERMONT POMEROY HALL, BURLINGTON, VT 05405
(802) 656-3861
(802) 656-2528
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00028353
BCBS
—
01
—
64088
MVP
—
Enumeration date
02/05/2007
Last updated
01/21/2010
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