Provider Demographics
NPI:1831210574
Name:GABORIAULT, SYLVIA MARIE (RD)
Entity type:Individual
Prefix:MS
First Name:SYLVIA
Middle Name:MARIE
Last Name:GABORIAULT
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:141 MAIN ST STE 1
Mailing Address - Street 2:
Mailing Address - City:MONTPELIER
Mailing Address - State:VT
Mailing Address - Zip Code:05602-2916
Mailing Address - Country:US
Mailing Address - Phone:802-249-1218
Mailing Address - Fax:802-249-1218
Practice Address - Street 1:141 MAIN ST STE 1
Practice Address - Street 2:
Practice Address - City:MONTPELIER
Practice Address - State:VT
Practice Address - Zip Code:05602
Practice Address - Country:US
Practice Address - Phone:802-249-1218
Practice Address - Fax:802-249-1218
Is Sole Proprietor?:No
Enumeration Date:2007-04-02
Last Update Date:2018-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT074-0000060133NN1002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1022360Medicaid
VT28596OtherBCBS PROVIDER NUMBER
VTY400121165OtherMEDICARE PTAN LINKED TO CVMC