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General NPI Number Information
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NPI Number | 1467312504
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Entity Type | Individual
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Provider Name | ROSEMARY MOORE MA
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Gender | Female
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Dates
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Enumeration Date | 11/12/2025
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Last Update Date | 11/12/2025
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Provider Practice Location Address
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Address Line | 4239 S BROWNELL RD
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City | WILLISTON
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State | VT
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Zip | 05495-7296
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Country | US
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Telephone | 802-328-9859
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Fax |
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Provider Business Mailing Address
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Address Line | 3280 RUE DE RUSHBROOKE
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City | VERDUN
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State | QC
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Zip | H4G 1S7
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Country | CA
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101200000X
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Taxonomy Name | Drama Therapist
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License Number | 097.0136694
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License Number State | VT
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