Individual
JOHN T MORAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA, LADC
Contact information
Practice address
51 FAIRVIEW ST, BRATTLEBORO, VT 05301-6629
(802) 254-6028
(802) 254-7501
Mailing address
1 HOSPITAL CT, STE 410, BELLOWS FALLS, VT 05101-1489
(802) 463-3294
(802) 463-1206
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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