Individual
KATHLEEN THAYER MALONEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
FAHC, 111 COLCHESTER AVE, BURLINGTON, VT 05401-1063
(802) 847-0000
Mailing address
44 CHARITY ST, BURLINGTON, VT 05401-1039
(802) 343-9403
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
055-0030766
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9000233
—
VT
Enumeration date
04/20/2006
Last updated
07/08/2007
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