Doctor Name: | SHARON MOFFATT |
NPI Number: | 1124149729 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCMHC |
License Number: | 0680000379 |
Business Practice Address: | 111 Main St Hyde Park, VT - 05655 |
Business Phone Number: | 8028886215 |
Business Fax Number: | 8028889474 |
Mailing Address: | Po Box 159, 111 Main St HYDE PARK |
State: | VT |
Postal Code: | 056550159 |
Phone Number: | 8028886215 |
Fax Number: | 8028889474 |
NPI Enumeration Date: | 04/02/2007 |
NPI Last Update Date: | 02/24/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 0680000379 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VT |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |