Provider Demographics
NPI:1760817969
Name:SYLVIA GABORIAULT WELLNESS SERVICES LLC
Entity Type:Organization
Organization Name:SYLVIA GABORIAULT WELLNESS SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:SYLVIA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:GABORIAULT
Authorized Official - Suffix:
Authorized Official - Credentials:RD,CDE
Authorized Official - Phone:802-249-1218
Mailing Address - Street 1:277 TAPLIN RD
Mailing Address - Street 2:
Mailing Address - City:BARRE
Mailing Address - State:VT
Mailing Address - Zip Code:05641-9787
Mailing Address - Country:US
Mailing Address - Phone:802-249-1218
Mailing Address - Fax:
Practice Address - Street 1:141 MAIN ST
Practice Address - Street 2:SUITE ONE
Practice Address - City:MONTPELIER
Practice Address - State:VT
Practice Address - Zip Code:05602-2905
Practice Address - Country:US
Practice Address - Phone:802-249-1218
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-06
Last Update Date:2013-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT074.0000060133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty