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NPI Code Detail

MEDICARE: MOLLY JULIA MCCABE RD

MEDICARE:   MOLLY JULIA MCCABE  RD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1133V00000XRegistered Dietitian074.0134481VT
2133V00000XRegistered Dietitian37004083AIN

General Provider Information

NPI Number : 1134998065
Entity Type Code : Individual
Provider Name (Legal Business Name) : MOLLY JULIA MCCABE RD
Provider Business Mailing Address
First Line : 180 S POINTE DR
Second Line :
City : SOUTH BURLINGTON
State : VT
Zip : 05403-4452
Country : US
Telephone Number : 802-355-6677
Fax Number :
Provider Business Practice Location Address
First Line : 142 W TWIN OAKS TER
Second Line :
City : SOUTH BURLINGTON
State : VT
Zip : 05403-7132
Country : US
Telephone Number : 802-355-6677
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/20/2023
Last Update Date : 10/10/2024

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Directions to “ MOLLY JULIA MCCABE RD” Practice Location

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