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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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