Individual
MOIRA A MULLIGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS CCC SLP
Contact information
Practice address
792 COLLEGE PARKWAY, MEDICAL OFFICE BUILDING, SUITE 102, UNIVERSITY OF VERMONT MEDICAL CENTER, COLCHESTER, VT 05446
(802) 847-2065
Mailing address
792 COLLEGE PARKWAY, MEDICAL OFFICE BUILDING, SUITE 102, UNIVERSITY OF VERMONT MEDICAL CENTER, COLCHESTER, VT 05446
(802) 847-2065
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
01031583
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
59895
BLUE CROSS BLUE SHIELD
—
01
—
711918
MVP
—
Enumeration date
02/21/2007
Last updated
02/22/2017
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