Healthcare Provider Details

I. General information

NPI: 1508775255
Provider Name (Legal Business Name): MOXIE SPEECH LANGUAGE THERAPY SERVICES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/07/2026
Last Update Date: 09/07/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

94 ZEPHYR RD
WILLISTON VT
05495-7414
US

IV. Provider business mailing address

94 ZEPHYR RD
WILLISTON VT
05495-7414
US

V. Phone/Fax

Practice location:
  • Phone: 802-227-2707
  • Fax: 802-341-6597
Mailing address:
  • Phone: 802-227-2707
  • Fax: 802-341-6597

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: JORDYN DEMONT
Title or Position: OWNER
Credential: MS., CCC-SLP
Phone: 607-342-2982