Doctor Name: | MR. DAN MORIARTY |
NPI Number: | 1174575971 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MSW, LICSW |
License Number: | 089-0000355 |
Business Practice Address: | Va Medical Ctr 215 North Main Street White River Junction, VT - 050090001 |
Business Phone Number: | 8022959363 |
Business Fax Number: | 8022966316 |
Mailing Address: | 4 Garnet St, LEBANON |
State: | NH |
Postal Code: | 037661867 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 05/17/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 089-0000355 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VT |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |