Individual
MARYANNE KYBURZ-LADUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
789 PINE ST, BURLINGTON, VT 05401-4933
(802) 864-0693
(802) 860-6613
Mailing address
600 BLAIR PARK RD, SUITE 190, WILLISTON, VT 05495-7586
(802) 872-4343
(802) 872-0282
Taxonomy
Speciality
Code
Description
License number
State
136A00000X
Registered Dietetic Technician
Primary
074-0000127
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1008797
—
VT
Enumeration date
04/17/2006
Last updated
06/06/2013
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