Stacey Moulton
Individual provider Active NPI Speech-Language Pathologist · Hyde Park, VT
NPI 1396469680 · NPPES record last updated Sep 29, 2022
Key facts
- NPI
- 1396469680
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 144.0114464 (VT)
- Practice address
- 110 Manning Rd
Hyde Park, VT 05655-9431 - Phone
- (802) 279-3359
- NPI assigned
- Sep 29, 2022
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 144.0114464 | VT | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 144.0114464 | VT | Yes |
Addresses
Primary practice location
110 Manning Rd
Hyde Park, VT 05655-9431
Mailing address
110 Manning Rd
Hyde Park, VT 05655-9431
Other providers in Hyde Park, VT
- Lamoille Restorative Center
- Patricia Joann Long
- Patricia L Marshall
- Susan A. Moore
- Eleanor M Morrissey
- Mari Nazzaro
- Jessyca Corey Nelle
- Helene S Nilsen
- Alison O'Connor Sutherland
- Kathryn C. Stackpole Osborne
All providers in Hyde Park, VT · Speech-Language Pathologist in Vermont
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 29, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.