Individual
MS. MARILYN JEAN RENAUDETTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A.
Contact information
Practice address
4185 ST GEORGE RD, WILLISTON, VT 05495-7695
(802) 651-7730
(802) 651-7730
Mailing address
55 IAN PL, WILLISTON, VT 05495-4408
(802) 764-1282
(802) 764-1282
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
047-0000736
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1015179
—
VT
Enumeration date
05/21/2008
Last updated
10/03/2008
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