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
—
—
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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